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WHY   DIE   SO   YOUNG? 


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WHY 
DIE  SO  YOUNG? 

By 
JOHN  B.  HUBER,  A.M.,  M.D. 

Sometime  Professor  of  Pulmonary  Diseases, 
The  Fordham  University  Medical  School; 
Fellow  of  The  American  Medical  Associ- 
ation; Fellow  of  The  New  York  Academy 
of  Medicine;  Writer  on  Hygiene,  Sanita- 
tion   and   Prophylaxis. 


HARPER  &  BROTHERS  PUBLISHERS 

NEW   YORK   AND    LONDON 


Why  Die  So  Young? 


Copyright,  192 1,  by  Harper  &  Brothers 
Printed  in  the  United  States  of  America 


To 

My  Wife's  Mother 
young  at  fourscore 
with  warm  affection 


CONTENTS 

CHAP. 

Prologue    . 

PAGE 

...                1 

Heredity — The  Marriage  of  Blood  Relations — The 
Alcoholic  Taint — Good  Blood — "Blood  Disease" — 
Tuberculosis — Scrofula — The  Rectification  of  Con- 
genital Defects — Imitation — Who  Are  the  Fit? — 
An  Aristoracy — Sickly  Infants — Diet  of  the  Nurs- 
ing Mother — Weaning — Pure  Milk — Bottle-feeding 
Is  Unnatural  Feeding — A  Precious  Possession. 

II.     Childhood 31 

The  Universal  Paramount — The  Healthful  Home — 
The  Air  We  Breathe — Pure  Water — Food — Harden- 
ing— The  School  Child — The  School — Exercise — 
Sense-Training — Medical  School  Inspection — Nutri- 
tional Disorders — The  Appendix — Heart  Disease  in 
Children — Tuberculosis  in  Children — Deformities — 
Infantile  Paralysis — Immunity — Aural  Disease — 
Eye  Defects — The  Teeth — Snuffles — Adenoids — 
Enlarged  Tonsils — St.  Vitus's  Dance — Night  Terrors 
— Tantrums — Mental  Defects — Morality  and  Physi- 
cal Deficiency. 

HI.   Youth 87 

The  Soul's  Awakening — Those  Yellow  Finger  Tips 
— John  Barleycorn — He  That  Ruleth  His  Spirit — 
The  Common  Cold — Influenza — Bronchitis — Pneu- 
monia— A  Case  of  Tuberculosis — The  Physiological 
Principles — The  Consumptive  Patient — The  Con- 
sumptive's Doctor — Bathing — Skin  Cancer — Great 
Aches  from  Little  Toe  Corns  Grow — Exercise — 
Walking — Physical  Training — The  Militia— The 
Hygienic  Life — Back  to  the  Land — Marriage. 


CONTENTS 

CHAP.  PAOB 

IV.  Maturity 142 

Human  Wear  and  Tear — The  Stout  and  the  Lean — 
The  Blood  Pressure  —  Auto-intoxication  — ■  The 
Athlete's  Heart — The  Use  and  Abuse  of  Drugs — 
Tea  and  Coffee — Nerve  Tests — The  Shoddy  Ner- 
vous System — Fatigue  Dyspepsia — Hysteria — The 
Emotions — Phobias — How  to  Rest — Neuritis — 
Catarrh — Typhoid  Fever — Malaria — Vaccination — 
The  Body's  Sentinels — Infection  Centers — The  Per- 
fect Human  Being? — The  Industrial  Surgeon — 
Fatigue  and  Efficiency — Alcohol  and  Efficiency — 
The  Benefit  of  Alcohol— The  Public  Health— The 
Sanitary  Conscience. 

V.  The  Prime  of  Life 197 

Life  Expectancy  After  Forty — Cancer — The  Pre- 
cancerous Stage — The  Chief  Danger  Signal — The 
Only  Cure  To-da.> — The  Moderate  Drinker — We 
Eat  Too  Much — Temperance  in  Eating — Gout — 
Overweights — Banting — The  Underweights — Func- 
tional Stomach  Disorders — Gastritis — A  Good 
Cook — Bright's  Disease — Diabetes — Rheumatism 
— Functional  Heart  Disturbances — Valvular  Heart 
Disease — The  Pace  That  Kills — Hardened  Ar- 
teries— Exercise  for  the  Middle  Aged — Does  God 
Fix  the  Death  Rate? 

VI.  Threescore  and  Ten 253 

Lagging  Superfluous? — The  Tragedy  of  Deafness — 
Visual  Defects — Cataract — Asthma — Chronic  Bron- 
chitis— The  Pneumonia  of  the  Elderly — Terminal 
Affections — Apoplexy — Sleep — Factors  of  Safety. 

VII.  Old  Age 283 

What  Does  It  Mean  to  Grow  Old?— The  Body  Cells 

— Dietary — Exercise  and  Warmth — Hobbies — Mu- 
sic— A  Good  Habit — A  Welcome  Friend. 

Appendix  A 297 

Appendix  B 301 

Index ?    303 


PROLOGUE 

The  theme  of  this  book  is  the  Healthful  Life, 
to  the  end  that  length  of  well-lived  days  may  be 
assured  us.  I,  a  physician,  am  urging  my  readers 
to  emulate  the  oyster,  which,  I  am  more  or  less 
credibly  informed,  has  no  diseases,  is  either  healthy 
or  dead.  Before  the  war  a  great  deal  was  written 
about  the  efficient  life.  An  eminent  statesman, 
now  passed  away,  through  many  years  urged  his 
compatriots  to  lead  the  strenuous  life.  Then  there 
is  the  religious  life,  which  should,  of  course,  be  led; 
the  moral,  the  spiritual,  the  intellectual  life,  and  so 
on.  It  is  very  likely,  indeed,  that  all  these  kinds 
of  life  shall  be  assured  him  who  will  but  live  the 
physiological,  the  hygienic  life. 

The  human  being  in  good  health  is  pretty  sure 
to  be  efficient  in  his  business  and  vigorous  in  his 
employments.  The  cleanliness  of  his  body  will 
either  make  him  godly,  as  that  clergyman-physician, 
John  Wesley,  assured  us,  or  as  nearly  so  as  the  most 
of  us  can  hope  to  be.  The  man  pure  in  body  is 
pretty  sure — anyway,  more  likely  than  not — to  be 
clean  as  to  his  morals.  And  in  the  sound  body  the 
intellectuals  can  safely  be  left  to  take  care  of  them- 
selves, as  the  ancients  recognized  better  than  we 
do  to-day. 

The  pessimist  will  get  no  pabulum  in  the  fol- 
lowing pages.     My  readers,  men  and  women,  will 


PROLOGUE 

find  nothing  to  perturb,  but  much,  I  hope,  provoc- 
ative of  thought,  to  the  end  that  they  may  safely 
and  pleasantly  attain  fourscore,  perhaps  the  cen- 
tury mark.  For,  as  we  shall  observe,  the  latter 
appears  to  have  been  the  intended  natural  human 
span. 

I  have  begun  each  division  of  this  book  with 
familiar  lines  of  Shakespeare;  indeed,  the  work 
is  a  consideration,  from  a  doctor's  viewpoint,  of 
humankind's  Seven  Ages. 


WHY    DIE    SO    YOUNG? 


WHY  DIE   SO  YOUNG? 
i 

INFANCY 

"  At  first  the  infant 
Mewling  and  puking  in  the  nurse's  arms.'* 

HEREDITY 

FRANCIS  GALTON  was  the  English  founder 
of  the  present  science  of  eugenics,  which  he 
defined  as  the  study  of  the  agencies  under  social 
control  that  may  improve  or  impair  the  racial 
qualities,  either  physical  or  mental,  of  future  gener- 
ations. He  was  himself  singularly  fortunate  in  both 
his  own  heredity  and  in  his  after-birth  environ- 
ment. Throughout  his  life  his  lines  were  cast  in 
most  pleasant  places.  And,  being  one  of  the  very 
kindliest  of  men,  he  was  enthusiastic  for  the  per- 
petuation, as  broadly  and  as  fully  as  human  life 
extends,  of  his  own  Olympian  status.  He  was 
sympathetically  desirous  that  all  humanity  should 
become  eugenized — well-born  in  the  very  best 
meaning  of  the  term — that  there  should,  more  than 
ever  in  human  history,  come  into  being  races  of 

gifted    artists,    saints,    mathematicians,    adminis- 

l 


WHY  DIE  SO  YOUNG? 

trators,  mechanicians,  and  the  like.  The  perfect 
man — the  physique  of  an  athlete,  the  mind  of  a 
scholar,  the  soul  of  a  saint — such  was  his  ideal. 
Above  all,  he  hoped  that  our  kind  should  be  free  of 
such  hereditary  stigmata  as  tend,  in  turn,  to  de- 
generated offspring. 

The  Galtonian  would  have  the  eugenic  principles 
go  hand  in  hand  with  love,  to  the  end  that  mar- 
riages may  make  ever  for  happier  homes  and 
healthier  children,  and  for  the  establishment,  in 
so  far  as  is  humanly  possible,  of  a  posterity  free 
from  insanity,  disease,  pauperism,  and  crime. 
Love,  in  a  mature  and  sensible  human  being  (but 
who,  in  love,  whatever  his  years,  has  ever  been 
sensible),  may  be  in  itself  a  eugenic  choice.  The 
fact  of  two  wholesome  beings  wishing  to  spend  their 
lives  together  is  likely  to  be  based  on  instinctive 
traits  that  will  make  for  good  inheritance,  to  be 
enjoyed  by  a  normal  posterity.  But  love,  of  itself, 
unserved  by  eugenic  principles,  "offers  no  more 
than  an  even  chance."  Understand  that  your 
thoroughgoing  eugenist,  wise  and  mellow-natured 
man  as  he  is,  would  not,  if  he  could,  do  away  with 
love;  he  would  preach  no  doctrine  of  scientific  mat- 
ing as  opposed  to  the  marriage  of  personal  choice; 
but  he  would  combine  with  love,  if  such  a  thing 
were  possible,  common  sense  and  forethought.  This 
science  of  eugenics  promises  to  do  a  great  deal 
of  good.  But  remember  that  nature  has,  in  a 
way  of  her  own,  been  practicing  it  these  some  six 
hundred  thousand  years  or  more,  and  doing  pretty 
well  at  it,  considering  how  much  human  civiliza- 
tion has  been  trying  to  frustrate  her.  Darwin  ex- 
pressed this  universal  phenomenon  in  his  law  of 


INFANCY 

the  survival  of  the  fittest.  By  far  the  most  of  our 
forbears  have  mated  well,  simply  because  they 
have  fallen  hopelessly  in  love  with  one  another, 
without  regard  to  any  other  consideration  and 
under  nature's  uninterfered-with,  wonderful,  and 
generally  wise  and  beneficent  influence.  Falling 
in  love  is  the  romantic  phrase  the  coldly  scientific 
equivalent  of  which  is  "natural  selection." 

For  my  part,  I  maintain  that  in  this  business  of 
eugenics  the  psychic,  the  spiritual,  is  the  all-impor- 
tant, the  supreme  factor;  the  essence  of  good  birth 
in  a  child  lies  in  the  noble  souls  of  its  parents. 
That  factor  obtaining,  the  right  human  organism 
should  surely  follow: 

"  For  of  the  soul  the  body  form  doth  take; 
Since  soul  is  form  and  doth  the  body  make."1 

If  people  will  only  just  fall  in  love,  without  re- 
gard to  other  and  more  or  less  worthy  considera- 
tions, the  eugenic  principles  may  pretty  safely  be 
chanced  to  take  care  of  themselves.  The  trouble 
really  is  that  very  frequently  considerations  other 
than  natural  affection  do  enter  into  marriage  en- 
gagements. Many  matches  are  made  for  and  not 
by  the  couple  who  are  to  marry;  great  wealth  or 
considerable  social  position  offsets  a  corrupt  body 
or  prevails  despite  disparity  in  years — and  so  on. 
Thus  does  what  we  may  here  term  the  negation  of 
eugenic  principles  frustrate  love,  and  so  make  for 
a  debased  rather  than  an  improved  race.  Let  us 
here  note  some  of  the  results  of  such  unfortunate 
unions,   as   tabulated,   both    before   Galton.   and 

1  Edmund  Spenser. 


WHY  DIE  SO  YOUNG? 

since  his  establishment  of  the  modern  science  of 
eugenics. 

THE   MARRIAGE   OF   BLOOD    RELATIONS 

If  two  epileptics  marry,  their  children  will  be  all 
epileptics;  the  same  is  true  of  imbeciles.  If  an 
epileptic  or  one  insane  marries  a  normal  individual, 
only  one-half  or  one-fourth  of  the  progeny  will 
usually  inherit  the  parental  abnormality;  the 
others,  according  to  the  Mendelian  theory  (the 
most  valid  in  science  to-day) ,  will  probably  be  nor- 
mal. A  recessive  trait  (one  present  in  undeveloped 
germ  form  and  never  becoming  active  in  the  life 
of  the  individual)  may  remain  recessive  for  genera- 
tiers  (atavism),  but  will  very  likely  become  active 
wLt  .?.  it  meets  a  like  trait,  recessive  or  otherwise. 

The  marriage  of  cousins  is  not  in  itself  bad.  if 
both  families  are  of  sound  stock.  But  such  mar- 
riages will  naturally  bring  out  any  common  un- 
toward traits  and  will  intensify  mutual  weaknesses. 
Thus  will  the  children  born  of  consanguineous  mar- 
riages tend  to  have  more  or  less  pronounced  stig- 
mata (signs  of  imperfect  mental  or  bodily  condi- 
tions), to  be  abnormal  in  one  way  or  another,  to  be 
deaf  mutes  or  albinos,  or  to  have  very  irregular  and 
early  decaying  teeth,  or  to  have  harelip,  or  squint, 
or  to  stammer  or  lisp.  Their  parents  have  the 
mutual  physical  and  moral  characteristics  which 
tend  to  become  exaggerated  in  the  children,  and 
this  because  those  traits  are  not  balanced  by  other 
and  diverse  ones. 

Sometimes  a  very  slight  disorder  may  grow  and 
become    intensified    through    several    generations, 

4 


INFANCY 

until  it  becomes  a  thing  really  dreadful.  It  is 
when  we  come  to  the  nervous  system  and  its  diseases 
that  we  find  a  wide  range  of  abnormalities.  This 
we  readily  understand  when  we  consider  that  the 
central  nervous  system  has  for  its  function  both 
the  bringing  of  every  organ  and  tissue  of  the  body 
into  harmonious  interrelation,  and  the  adjusting 
of  the  body  as  a  whole  to  its  environment — that 
is,  to  the  universe  outside  it.1  Children  will  not 
by  any  means  always  suffer  the  nervous  maladies 
of  their  parents  or  other  forbears;  what  they  will 
inherit  is  an  untoward  predisposition,  a  tendency. 
And  the  kind  of  nervous  aberrations  which  the 
child  will  manifest  will  depend  largely  on  the  bane- 
ful influences  the  child  may  be  subjected  to  after 
birth.  Such  an  unfortunate  child  may  thus  de- 
velop epilepsy,  or  alcoholism,  or  sexual  perversity, 
and  so  on. 

THE   ALCOHOLIC    TAINT 

The  alcoholic  taint  is  certainly  the  most  unfor- 
tunate that  can  be  bequeathed;  yet  even  this, 
like  all  the  others,  can  be  fought  and  lived  down 
by  the  heroic  soul.  The  offspring  of  chronic  inebri- 
ates are  badly  developed;  they  are  likely  to  be 
undersized,  morose  or  melancholy  in  disposition, 
or  hysterical  and  acutely  sensitive.  Or  they  may 
be  wonderfully  precocious  and  manifest  the  highest 
genius,  perverse  though  it  is  likely  to  be.  They 
lack  especially  poise,  these  unhappy  children,  and 
are  weak  in  attention  and  will  power.  Their  be- 
havior is  apt  to  be  odd,  tending  even  to  the  demi- 

1  Normal  living  is  the  right  adjustment  of  internal  relations  to  ex- 
ternal relations. — Herbert  Spencer. 
2  5 


WHY  DIE  SO  YOUNG? 

fouSy  the  half -mad  state.  The  weakness  of  their 
nervous  systems  may  express  itself  in  a  deficient 
moral  sense  and  in  irresistible  impulses  to  do  wicked 
things.  Sometimes  such  pathetic  children  become 
downright  insane. 

GOOD   BLOOD 

How  delightful  a  volume,  on  the  other  hand, 
could  be  written  on  the  wholesome  aspects  of 
heredity!  How  pleasant  it  would  be  to  dwell  on 
the  splendid  and  exquisite  qualities  of  mind  and 
heart  and  body  that  are  transmitted;  on  how  in- 
tellectual and  romantic  and  finely  emotional  apti- 
tudes are  intensified  in  those  fortunately  born! 
We  would  turn  gratefully  from  the  consideration 
of  baneful  heredity  to  books  of  biography,  which 
tell  on  every  page  of  families  through  which,  for 
several  generations,  there  have  been  born  great 
scientists,  physicians,  jurists,  statesmen,  humani- 
tarians, merchants,  sailors,  soldiers,  beautiful  and 
dear  women,  writers  of  lovely  verse,  painters,  and 
the  like.  For  but  one  instance  among  thousands 
— that  of  Sebastian  Bach,  whose  music  is  so  noble 
and  so  satisfying;  his  family,  beginning  with  Weit 
Bach,  in  1550,  continued  through  eight  generations 
to  produce  musicians,  twenty-nine  of  whom  at- 
tained real  and  solid  eminence,  the  fame  and  the 
beneficence  of  one  of  whom,  at  least,  shall  never  die! 

Marriage  with  an  individual  of  bad  blood,  then, 

will  tend  to  drag  down  an  inheritance  of  good  blood ; 

imbecility  is  thus  often  introduced  into  "bloodlines" 

that  have  hitherto  been  good.     One's  inheritance 

cannot  always  be  judged  from  a  consideration  of 

6 


INFANCY 

the  parents  alone,  for  normal  parents  may  have 
abnormal,  even  criminal,  children;  the  inheritance 
must  be  traced  back  for  generations  and  the  records 
of  cousins,  aunts,  brothers,  and  sisters  must  be 
examined.  One  does  not  inherit  from  his  parents, 
but  from  the  "germ  protoplasm." 

There  seems  to  be  no  hereditary  danger  with 
regard  to  cancer  except  when  the  disease  has  been 
on  both  sides  of  the  family  ancestry.  Certain  of 
the  disease  tendencies  we  are  born  with  do  not 
manifest  themselves  in  infancy,  or  in  childhood, 
or  even  in  youth.  Tuberculosis,  as  we  shall  pres- 
ently see,  is  here  an  exception.  They  may  be 
latent,  some  of  those  tendencies,  until  past  two- 
score,  when  they  take  their  part  in  the  degenerations 
and  abnormalities  which  we  shall  consider  in  the 
latter  part  of  this  book. 

It  remains  now  to  consider  the  possible  parental 
transmission  of  infectious  diseases,  such  as  have 
germs  for  their  specific  or  essential  causes.  Of 
these  we  must  here  emphasize  two,  by  reason  of 
their  enormously  deterrent  effect  on  the  happiness 
and  the  well-being  of  mankind. 

"blood  disease" 

Perhaps  the  most  dreadful  of  all  hereditary 
diseases  is  that  which  is  probably  referred  to  in  the 
Scriptural  commandment  relating  to  the  sins  of 
the  fathers  that  shall  be  visited  upon  the  children 
unto  the  third  and  fourth  generation.  Children 
thus  miserably  affected  oftentimes  die  sadly  enough 
— and  yet  fortunately — in  infancy.  If  they  con- 
tinue to  live  they  are  likely  to  be  weaklings,  to 


WHY  DIE  SO  YOUNG? 

grow  up  with  poor  constitutions,  to  develop  slowly 
in  both  mind  and  body;  their  teeth  are  likely  to 
be  very  poor  and  late  in  coming;  they  may  be  born 
deaf  and  they  may  have  eye  troubles,  may  even  be 
born  blind.  They  may  be  deformed;  they  may 
have  the  various  stigmata  I  have  thus  far  men- 
tioned; and  others  which  were  better  stated  by 
the  family  doctor  than  dwelt  on  here.  Nor  may 
such  stigmata  appear  until  the  child,  in  its  turn, 
has  reached  maturity,  becomes  venerable  even. 
And  then,  instead  of  a  hale  and  hearty  old  age, 
spent  with  ease  and  dignity,  these  stigmata  may, 
all  belated,  appear  and  bear  the  gray  head  in  sorrow 
to  a  premature  grave.1  Anyone  who  wants  to  get 
the  full  force  of  these  observations  should  go  to  see 
Ibsen's  "Ghosts,"  a  play  perfectly  well  founded  on 
fact. 

TUBERCULOSIS 

The  parent  almost  never  transmits  the  germ  of 
tuberculosis,  or  consumption,  to  the  offspring;  but 
the  tendency,  the  predisposition  to  consumption, 
is  often  transmitted.  Such  being  the  case,  marriage 
of  the  tuberculous  should  be  most  earnestly  depre- 
cated, certainly  while  the  disease  is  active  in  the 
system.  Especially  for  her  own  sake,  without 
respect  to  possible  offspring,  should  no  tuberculous 
woman  be  permitted  to  marry.  In  her  case  there  is 
ever  the  possibility  of  death  in  childbirth,  the 
probability — should  that  crisis  be  survived— of 
physical  wreck  and  death  by  lingering  stages  sub- 
sequent to  the  birth.    When  consumption  is  hang- 

1 1  should  have  been  called  in  this  case  fifty  years  ago. — An  eminent 
consultant. 

8 


INFANCY 

ing  about  a  girl  the  distance  between  the  marriage 
bed  and  the  grave  is  usually  short  with  her;  the 
husband,  if  he  does  not  become  a  widower  soon 
after  the  birth  of  the  first  child,  may  count  upon 
a  perpetually  ailing  wife.  And  as  to  the  other 
side  of  the  distressing  picture,  "Many  a  young 
man  has  sacrificed  his  chance  of  recovery  on  the 
altar  of  Hymen." 

A  consumptive  should  not  marry  a  person  in 
health,  especially  if  this  disease  has  existed  a  long 
time  and  is  progressive;  besides,  a  latent  and  com- 
paratively innocuous  tuberculous  "spot"  or  area 
in  the  body  may,  through  marital  stresses,  develop 
into  an  active  and  fatal  lesion. 

But  should  no  one  who  has  ever  had  consumption 
marry?  May  no  one  who  has  been  consumptive 
and  who  does  not  thereafter  evidence  the  disease 
venture  upon  this  blessed  step?  Emphatically, 
there  should  be  no  marriage  while  the  disease  is 
in  the  slightest  evidence.  However,  after  there 
has  been  what  the  doctors  term  a  relative  recovery, 
after  the  disease  has  been  for  two  or  three  years 
arrested — that  is,  practically  cured — if  there  are 
no  discoverable  symptoms  and  a  satisfactory  gen- 
eral condition  is  manifest,  marriage  need  not  be 
objected  to.  If  a  man  be  financially  fortified 
against  the  possibility  of  poverty  or  of  undue 
worldly  stress,  and  if  his  wife  make  no  undue 
hymeneal  demands  upon  him,  he  may  be  better 
off  married  than  a  bachelor  with  all  the  unhappi- 
ness  contingent  upon  that  lugubrious  state.  On 
the  other  hand,  a  woman  may  be  much  more  seri- 
ously harmed  by  marriage  than  a  man,  because 
of  the  greater  taxes  upon  the  feminine  physique. 


WHY  DIE  SO  YOUNG? 

For  wifehood  a  woman  should  ever  be  strong  and 
fit,  not  only  for  her  own  sake,  but  also  for  that  of 
her  offspring,  and  we  are  at  present  especially 
concerned  with  the  latter.  The  disease  in  the 
mother  is  very  likely  to  assume  its  most  acute  form 
after  her  confinement;  and  it  then  proves  rapidly 
fatal.  Multiple  births  should  especially  be  dis- 
couraged for  such  mothers.  During  the  months 
before  birth  the  infant's  body  cells  are  becoming 
differentiated  for  their  several  offices,  and  the  organs 
are  formed,  increase  in  size,  and  begin  to  take  on 
their  allotted  functions.  It  is  during  this  season 
that  the  organism  of  the  coming  babe  is  most  acutely 
sensitive  to  its  own  and  peculiar  environmental 
impressions — such  as  variations  in  the  oxygen  sup- 
ply, or  in  the  warmth  and  constitution  of  the 
mother's  blood.  Several  months  before  the  birth, 
therefore,  the  mother  should  be  safeguarded  even 
more  than  ordinarily;  she  should  be  assured  whole- 
some diet,  sensible  and  hygienic  clothing;  should 
rest  well  at  night,  and  for  an  hour  after  lunch; 
have  frequent  baths  in  tepid  water — and  like 
familiar  measures  should  obtain;  especially  should 
she  be  subjected  to  no  unusual  mental  strain  or 
excitement. 

SCROFULA 

Even  so,  the  child  may  be  born  with  the  tendency 

to  tuberculosis;   it  may  be  scrofulous,  as  the  older 

medical  writers  used  to  term  the  condition.     The 

child,  be  it  understood,   is  not  tuberculous — not 

yet;   because  parental  transmission  of  the  tubercle 

bacillus — the  essential  germ  of  tuberculosis — is  most 

rare;  the  tissues  of  such  a  scrofulous  child,  however, 

10 


INFANCY 

provide   an   all   too   congenial   soil   for  the  post- 
natal implantation  of  the  specific  germ. 

Such  scrofulous  children  are  born  weak  and  sickly. 
Their  skin  is  pallid,  their  flesh  flabby;  inflamma- 
tions which  tend  to  a  sluggish  course  and  are  diffi- 
cult to  heal  occur  on  the  slightest  provocation  in 
the  mucous  membranes.  And  so  they  have  sore 
eyes,  these  poor  infants,  coryza,  sore  lips,  mouth 
eruptions,  congested  and  unhealthy  throats,  ob- 
stinate bronchitis,  stomach  and  intestinal  dis- 
orders. The  lymphatic  vessels  and  glands  are 
easily  involved;  the  glands  in  the  neck  become 
prominent;  there  are  adenoids,  and  enlarged  or 
otherwise  diseased  tonsils.  Such  infants  are  slow 
teethers;  ansemic  (weak-blooded),  mouth  breath- 
ers, starved  for  oxygen;  all  the  bodily  processes  are 
torpid  and  inadequate  for  the  needs  of  the  frail 
economy.  There  may  be  scrofulous  chest  malfor- 
mations, pigeon  or  keel  breast;  bone  disease  re- 
sulting in  hunchback;  stunted  and  wizened  growth; 
breathing  capacity  below  the  average;  deficient  de- 
velopment of  the  circulatory  apparatus;  perhaps 
an  undersized  heart. 

THE  RECTIFICATION   OF   CONGENITAL  DEFECTS 

Rectification  to  the  normal  average  may  be  im- 
possible. Nevertheless,  very  much  indeed  can  be 
done  by  the  steadfast  co-operation  of  the  parent, 
the  doctor,  and  the  nurse  to  mitigate  abnormal 
conditions,  not  only  for  the  child  itself,  but  also 
in  order  to  avoid  baneful  effects  upon  future  gen- 
erations.   Here  we  have  for  our  comfort  the  dictum 

of  the  evolutionists  that  Nature  does  her  best  to 

11 


WHY  DIE  SO  YOUNG? 

compensate  for  the  sins  that  are  committed  against 
her  beneficent  courses,  and  to  bring  the  abnormal 
individual  back  to  the  normal  of  its  type.  Nature 
does  also  what  may  appear  a  cruel  thing,  but  which 
is  in  reality  a  very  blessed  course,  both  for  the  de- 
generately born  infant  and  for  the  whole  race  as 
well.  The  unions  of  depraved  parents  are  for  the 
most  part  unproductive,  while  most  of  the  off- 
spring of  epileptics,  imbeciles,  and  the  like  are 
either  stillborn  or  they  die  within  their  first  year. 
Thus  does  Nature  attend  to  our  devolutionary  mis- 
adventures without  the  help  of  reformers  and  legis- 
latures. It  is  also  encouraging  to  recall  that  func- 
tional aberrations  from  the  normal,  while  more 
likely  to  be  transmitted  than  anatomical  stigmata, 
are  nevertheless  more  amenable  to  treatment. 
Although  there  may  be,  fortunately,  no  definite 
anatomical  stigmata,  the  "pernicious  nutritive 
habit"  may  be  transmitted;  and  this  it  is  the 
business  of  the  physician,  the  parent,  and  the 
humanitarian  to  detect  and  to  combat.  Such  in- 
fantile sufferers  will  have  to  be  kept  under  con- 
stant observation,  not  for  weeks  or  months,  but 
for  years.  These  statements,  while  applicable 
directly  to  tuberculosis,  are  pertinent  also  to  other 
diseases  and  disease  tendencies  transmitted  by  the 
parent. 

I,  for  my  part,  feel  very  strongly  regarding  the 
aspects  of  heredity  I  have  thus  far  dwelt  upon. 
What  physician  of  long  practice  and  experience,  have 
he  but  a  minimum  of  humanity  and  of  sympathy 
for  his  kind,  can  be  callous  in  these  premises? 
And  therefore  I  dwell  a  little  further  on  the  subject. 

Long  before  Galton   and   Darwin   and   Mendel 
12 


INFANCY 

has  abnormal  psychology  fiction  been,  with  fair 
accuracy,  based  on  such  facts  as  we  have  here  been 
considering.  As  in  The  House  of  the  Seven  Gables, 
"We  sleep  in  dead  men's  houses;  we  are  sick  of 
dead  men's  diseases;  we  live  in  dead  men's  lives. 
The  past  lies  upon  the  present  like  a  dead  giant's 
body;  and  it  is  as  if  a  young  giant  were  compelled 
to  waste  his  strength  in  carrying  about  the  corpse 
of  an  old,  an  atavistic  giant."  Read  also  the 
novel,  Archibald  Malmaison,  by  Julian,  Nathaniel 
Hawthorne's  equally  gifted  son. 

And  as,  on  the  other  side  of  the  picture,  the 
ancients  maintained  their  Three  Fates,  whom  no 
child  born  of  woman  could  hope  to  withstand, 
we  moderns  have  also  our  Three  Fates — Heredity, 
Environment,  and  Function — all  three  most  power- 
ful factors  in  shaping  our  individual  destinies  for 
better  or  for  worse.  But  we  recognize  also  the 
divine  gift  of  the  human  will.  Is  the  heredity 
bad?  Marvels  may  be,  are  every  day,  performed, 
when  the  will  to  live  well,  seeking  and  finding  the 
right  environment,  determines  furthermore  upon 
a  wise  subordination  and  a  steadfast  regulation  of, 
the  bodily  functions.  Thus  will  the  resolute  will, 
the  prayerful  will,  fight  down  successfully  almost 
any  vicious  inherited  tendency. 

IMITATION 

The  question  of  the  proportionate  relations  of 
heredity,  environment,  function,  will,  and  other 
factors  in  the  development  of  the  individual,  fur- 
nishes never-ending  controversy.  Some  tell  us 
that  heredity  counts  for  everything,  and  that,  not 

J? 


WHY  DIE  SO  YOUNG? 

being  blessed  with  the  superlative  brand,  one  is 
as  good — or  as  bad — as  foreordained  to  perdition. 
Others  lay  all  stress  on  environment;  others  are 
altogether  for  other  factors.  "When  doctors  dis- 
agree who  shall  decide?"  and  the  doctor  who  is 
writing  this  has  neither  a  valid  position  to  advance 
nor  an  inclination  to  further  befuddle  the  issues. 
I  am  wondering,  however,  if  the  factor  of  imitation 
may  not  have  something  to  do  with  the  case. 

I  talked  recently  with  an  orthodontist  who  main- 
tained that  heredity  had  very  little  to  do  with 
queer  features  and  homely  jaws  and  crooked  teeth. 
I  reminded  him  that  families  are  known  through 
many  generations  to  have  had  family  character- 
istics— the  Hapsburg  chin,  for  example,  which  is 
as  typical  in  the  present  king  of  Spain  as  it  was  in 
his  forbear,  Philip  the  Second,  several  centuries 
ago.  I  have  seen  a  book  on  that  subject  which 
gives  many  portraits  of  men  and  women  in  the 
Hapsburg  family,  every  one  of  them  big  chinned. 
But  my  friend  declared  that  my  instance  proved 
nothing;  that  imitation  was  here  at  work  and  not 
heredity.  WHiat  infant,  seeing  big-chinned  people 
constantly  about  it,  would  not  exercise  its  basic 
faculty  of  imitation,  would  not  be  constantly 
working  its  plastic  baby  chin,  so  as  to  have  it  cor- 
respond with  the  biologic  chin  scheme  constantly 
presented  for  its  observation  and  becoming  part 
and  parcel  of  its  experience?  Give  a  baby  a  bull- 
dog for  a  companion  and  it  will  sit  for  hours  trying 
to  imitate  the  ugly,  though  amiable  and  sociable,  jaw 
of  its  pet.  The  same  with  the  Teddy  bear,  which 
is  so  perverse  a  substitute  for  the  girl  baby's  doll. 

Thus  contended  my  orthodontist  friend.     And 

14 


INFANCY 

if  he  is  right  as  to  facial  expression,  may  not  his 
view  be  equally  valid  for  the  thousand  and  one 
characteristics  babies  are  maintained  by  many  facile 
scientists  to  be  born  with. 

WHO   ARE   THE   FIT? 

Another  consideration  in  this  place.  The  ques- 
tion is  proposed  by  some:  "Would  it  not  be  better 
for  the  race  in  general  if  its  weaklings  were  left 
to  die  off — humanely,  of  course — soon  after  their 
birth?  Are  not  the  efforts  of  doctors  and  nurses, 
of  parents  and  humanitarians,  to  preserve  the  lives 
of  sickly  infants  really  misdirected,  in  that  they 
violate  the  Darwinian  law  of  the  survival  of  the 
fittest?  Is  not  the  presence  among  us  of  the 
weakling  an  additional,  an  unfair,  and  a  useless 
burden  upon  the  strong,  and  a  handicap  upon  the 
fit  in  their  development,  and  their  progress?  Were 
not  the  Spartans  wiser  than  we  in  throwing  to  the 
wolves  their  unhealthily  born  babes?  Were  they 
not  right  in  considering  that  the  claims  of  the 
individual  and  of  the  race  involved  a  contradiction 
that  could  be  wisely  disposed  of  in  but  one  way; 
that  to  save  a  sickly  infant  would  be  contrary  to 
communal  hygiene,  the  ultimate  object  of  which 
should  be  the  improvement  cf  the  race? 

The  error  in  such  argument  appears  to  be  in 
considering  that  this  tenet  of  the  survival  of  the 
fittest  is  to  be  taken  only  in  the  physical  sense; 
whereas,  if  it  is  to  have  the  slightest  value  in 
philosophy,  it  must  be  indicative  of  evolution  in 
all  its  aspects. 

Evolution,  to  be  a  philosophy  worthy  the  name, 

15 


WHY  DIE  SO  YOUNG? 

must  be  an  all -comprehending  system,  upon  which 
consistent  living  can  be  based;  it  has  got  to  con- 
sider not  only  the  merely  material,  but  all  other 
phases  of  life  as  well — the  mental,  the  moral,  the 
emotional,  and  the  spiritual — an  evolution  inclusive 
of  the  humanities.  For  no  philosophic  doctrine 
is  surer  than  that  the  physical,  the  mental,  and 
all  other  phases  of  existence  are  inseparable  and 
mutually  affecting  and  affected  parts  of  the  in- 
dividual being.  The  coldest  political  economists, 
the  most  practical  statesmen,  will  grant  this,  as 
well  as  those  most  susceptible  to  the  emotional — 
at  least  they  will  if  they  are  men  experienced  in 
dealing  with  human  conditions  at  first  hand.  On 
such  basis,  then,  a  sympathy  for  the  weak  and  the 
afflicted,  and  a  helpful  endeavor  for  their  return 
to  health  and  strength,  is  altogether  logical;  other- 
wise the  conclusion  were  inevitable  that  civiliza- 
tion, the  iville  zum  guten,  altruism,  and,  of  course, 
Christianity,  have  been  and  are  now  colossal 
blunders,  and  worse. 

Who  would  indeed  have  the  hardihood  to  take 
it  upon  himself  to  discriminate,  or  to  select  from 
among  his  fellow  humans  the  "fittest"  for  survival? 
How  many  a  man,  how  many  a  woman,  who  has 
later  in  life  given  substantial  comfort  to  others, 
has  yet  been  unhealthily  born,  and  has  had  his 
or  her  infant  life  hanging,  month  by  month,  by  a 
thread,  until  the  scale  has  been  turned  existence- 
ward,  with  results  most  beneficial  to  our  kind! 
How  many  a  weakling,  having  triumphantly  grown 
to  manhood  and  womanhood,  has  made  great  im- 
pression upon  our  civilization,  to  the  universal 
good  and  profit! 

16 


INFANCY 

Dr.  Elizabeth  Blackwell,  who  never  married, 
and  who  desired  to  adopt  a  child,  visited  an  asylum 
to  this  end.  They  showed  her  many  children.  She 
looked  them  all  over  very  carefully,  and  finally 
selected  the  most  unpromising  and  an  apparently 
vicious  little  girl,  explaining  her  choice  thus,  "I 
will  take  this  one  because  I  think  she  needs  me  the 
most."  And  it  would  make  your  eyes  well  up  to 
read  how  superabundantly  she  was  repaid  with 
the  undying  affection  and  devotion  of  the  "out- 
cast," who  grew  up  into  splendid  and  most  service- 
able womanhood  under  the  fostering  care  of  that 
"beloved  physician." 

Have  you  ever  heard  of  Smiling  Joe,  who, 
having  Pott's  disease  of  the  spine,  lay  for  two 
years  on  his  back,  strapped  to  a  surgical  frame, 
so  that  he  might  not  die  of  bone  consumption; 
so  that,  in  any  event,  he  might  not  grow  up 
a  hunchback?  Had  not  this  sick  tenement  child 
better  have  been  left  to  perish;  or,  speaking 
by  the  book,  had  he  not  best  have  undergone 
elimination  in  the  process  of  the  survival  of  the 
fittest? 

Well,  by  just  lying  on  his  little  back,  and  smiling 
unflinchingly  through  all  his  sufferings,  by  keeping 
on  smiling  the  smile  that  just  would  not  and  could 
not  come  off,  tenement  Joe  effected  more  than 
most  of  the  able-bodied  among  us  have  ever  hoped 
to  do  or  have  ever  achieved.  Principally  by  pub- 
lication throughout  practically  the  whole  of  civil- 
ization, of  a  picture  of  his  winsome  little  face,  of 
his  enduring  smile,  and  cf  his  patient  little  body 
strapped   to   that   frame,   a  quarter  of   a  million 

dollars  was  collected,  with  which  a  hospital  for 

17 


WHY  DIE  SO  YOUNG? 

tuberculous  children  was  built,  down  by  the  sea- 
shore, within  the  metropolitan  bounds. 


AN   ARISTOCRACY 

And  yet  the  infant  should  start  life  as  little  handi- 
capped as  possible.  Most  true  is  it  that  every 
child  has  the  inalienable  right  to  be  born  pure- 
blooded,  and  disease  and  deformity  free.  Its  hered- 
ity and  its  environment  cannot  be  any  too  much 
in  its  favor.  And  from  its  first  cry  its  functions 
should  be  as  well  ordered  as  possible,  if  it  is  to  live 
rightly  throughout  its  Seven  Ages.  The  situation 
has  its  social  aspects.  And  it  is  most  refreshing 
to  observe  the  efforts  that  are  now  making  for  the 
welfare — ab  initio — of  the  children  of  our  people: 
for  example,  the  work  of  the  Children's  Bureau 
of  the  Department  of  Labor  at  Washington,  which 
reports  the  existence  of  an  aristocracy  at  Brockton, 
Massachusetts — one  into  which  one  may  not  hope 
to  climb — into  which  one  has  to  be  born.  Only 
babies  who  can  meet  five  requirements  can  boast  of 
belonging  to  that  inner  circle. 

First  point:  The  baby's  father  must  have  been 
earning,  and  must  be  earning,  a  comfortable  living 
wage.  In  this  circumstance  alone  are  one's  chances 
of  healthful  longevity — an  essential  to  any  aris- 
tocracy worth  while — greatly  improved.  And  de- 
spite all  that  may  be  advanced  to  the  contrary, 
poverty  and  want  are  dreadful  restrictives  of  mental 
and  physical  completeness.  Fifty -five  per  cent  of 
Brockton's  babies  were  blacklisted  because  their 
fathers'  earnings  were  below  the  admission  stand- 
ard, according  to  which  one's  layettes  must  be  of 

18 


INFANCY 

a  certain  prescribed  quality;  according  to  which 
the  perambulator  in  which  one  is  chauffered  to 
five-o'clock  milks  must  be  of  something  above  the 
H.  F.  or  common  make  of  car.  The  Children's 
Bureau  shows  that  when  fathers  earn  above  $1,000 
a  year,  the  deaths  of  the  babies  average  60  per  1,000; 
when  they  earn  from  $850  to  $1,000  the  average  is 
95;  when  they  earn  from  $550  to  $850  the  average 
is  120,  and  with  those  who  earn  under  $550  the 
average  baby  death  is  160  per  1,000. 

Second  point:  The  baby's  mother  must  not  have 
been  gainfully  employed  during  either  the  year 
before  or  the  year  after  its  advent.  Of  course, 
this  is  to  give  up  the  fundamental  woman's  right 
to  contend  with  the  mere  male  in  his  own  field, 
regardless  of  her  so  manifest  physical  disqualifica- 
tions, or  of  the  race's  bitter  cry  for  the  natural 
development  of  its  individuals.  And  yet,  if  we 
are  to  avert  universal  disaster,  we  have  got,  once 
and  for  all,  to  reach  a  decision:  Which  is  it  to  be, 
natural  mothering  or  race  degeneration?  mother 
love  or  a  rotting  civilization? 

Well,  any  baby  in  this  aristocracy  (and  there  is 
in  all  the  cosmos  no  tyrant  that  demands  and  will 
have  so  much  as  a  baby)  has  the  right  to  cast  the 
aspirant  into  outer  darkness,  saying:  "Your  mother 
has  no  business  working  in  a  factory  or  wearing 
herself  out  over  boarders.  She  should  be  as  my 
mother,  who  gives  all  her  time  to  taking  care  of 
me.  And  goodness  knows,  she  is  at  it  day  and 
night — and  sometimes  father,  too — at  night,  any- 
way.   No,  clearly,  you  are  not  eligible  to  our  set." 

The  Children's  Bureau  notes  that  the  mothers 
of  less  than  one-fifth  of  the  Brockton  babies  were 

19 


WHY  DIE  SO  YOUNG? 

gainfully  employed  during  some  part  of  their  babies' 
first  year,  though  none  of  them  should  have  had 
to  work  that  way.  The  count  is  better  than  in 
neighboring  New  Bedford,  forty  among  one  hundred 
of  whose  mothers  worked  away  from  home  to  sup- 
plement the  family  income.  On  the  other  hand, 
New  Bedford  must  be  presumed  to  boast  with 
pride  of  considerably  more  hard-cash  prosperity 
to  offset  her  Gradgrinding  of  maternal  flesh  and 
blood. 

Third  point:  The  baby's  mother  must  have 
had  at  least  fair  medical  care  when  it  was  born 
and  during  her  confinement.  The  care  of  the  new- 
comer must  have  been  foreseem  and  its  nurture 
arranged  for  long  before  its  advent.  Expectant 
motherhood  must  have  been  honored  and  its  just 
dues  provided  for. 

Fourth  point:  Both  father  and  mother  must 
have  been  able  to  read  and  write.  Of  course,  the 
illiteracy  test  for  the  parents  will,  at  first  sight,  ap- 
pear in  itself  to  be  about  as  absurd  as  if  we  were  to 
expect  the  baby  to  be  born  reading  the  Commen- 
taries of  Julius  Caesar.  And,  of  course,  wonder- 
fully fine  babies  were  born  some  several  hundred 
thousand  years  before  anybody  ever  knew  how  to 
read  and  write.  And  yet  modern  social  and  eco- 
nomic conditions  are  such  that  this  requisite  estab- 
lished by  the  Children's  Bureau  for  inclusion  in 
any  baby  aristocracy  is  justified  by  reason  that 
invaluable  sources  of  sanitary  and  hygienic  in- 
formation are  likely  to  be  closed  to  illiterate 
parents. 

Fifth  point:     The  house  the  baby  is  to  live  in 

must  have  been  and  be  well- ventilated,  clean,  sani- 

20 


INFANCY 

tary,  and  not  overcrowded.  The  greatest  Brockton 
infant  mortality  was  found  in  the  most  squalid 
and  congested  homes.  The  baby  who  would  qualify 
for  the  Brockton  aristocracy  must  not  be  of  a 
family  the  whole  of  which  occupies  but  one  room 
and  which  takes  in  others  beside  the  family  to 
live  with  them. 

These  five  considerations  have  been  required  cf 
any  baby  who  would  be  of  the  infantile  haul  ton, 
because  the  Bureau's  study  of  some  25,000  babies 
has  proven  their  worth  in  saving  babies'  lives. 

SICKLY    INFANTS 

A  weak  and  consumptive  mother  should  not 
nurse  her  infant.  There  is  little  likelihood  of  her 
milk  itself  being  infected;  there  is  much  more 
likelihood  of  the  infant  being  infected  by  the 
mother's  cough  as  it  lies  upon  the  breast.  But  the 
milk  of  such  a  mother  is  not,  in  general,  sufficiently 
nutritious;  besides,  lactation  is  a  great  drain  upon 
her  already  depleted  strength.  Recourse  must  then 
reluctantly  be  made,  for  the  reasons  we  shall  note, 
to  modified  milk  of  the  cow.  Such  modifications 
should  conform  to  the  individual  infant's  needs; 
the  proportions  of  the  various  ingredients,  milk, 
limewater,  sugar  of  milk,  cream,  and  perhaps 
cereals,  must  be  proportioned  according  to  the 
"symptom  complex"  presented  by  each  infant. 
The  matter  is  thus  pre-eminently  within  the  family 
physician's  province;  wherefore  it  is  not  dwelt  on 
here. 

Artificially  fed  infants — that  is,  babies  fed  on  the 
bottle — are  specially  prone,  in  the  hot  and  humid 
3  21 


WHY  DIE  SO  YOUNG? 

summer  months,  to  dysenteries,  to  inflammations 
of  the  digestive  tract;  for  these  ailments  the  germs 
multiplying  in  cow's  milk  are  almost  entirely 
responsible.  For  such  ailing  infants  and,  indeed, 
for  most  suffering  babies  and  little  children,  of 
whatever  infection,  and  the  convalescent  from 
disease,  sea  air  is  most  beneficial. 

Infants  and  children  are  indeed  peculiarly  bene- 
fited at  the  seashore.  Children  having  the  kind 
of  tuberculosis  peculiar  to  their  months  and  years, 
the  conditions  we  have  mentioned,  and  also  the 
bone,  joint,  and  gland  tuberculosis — the  white 
swellings,  or  cold  abscesses  of  bone  and  joint — are 
especially  apt  to  get  well,  in  most  cases,  without 
operation.  Many  an  infant  you  would  not  believe 
had  another  hour  to  live  improves  within  that 
very  hour  of  its  arrival,  and  is  cured  as  by  a  miracle. 
Thus  there  are  many  blessed  hospitals  for  such 
children  along  our  coasts.  Not  only  are  the  winds 
of  the  sea  germ  free  (most  diseases  are  germ- 
induced),  but  this  air  of  heaven  is  also  saturated 
with  the  iodine,  the  sodium,  and  the  other  halogen, 
healing  salts,  from  the  breaking  of  the  waves  and 
the  dashing  of  the  spray  upon  the  beaches.  The 
crisp  saline  odor  from  the  evaporation  of  the  ex- 
tractives in  sea  water  is  strongest  during  a  storm, 
when  the  billows  dash  tumultuously  upon  the  sea- 
weeded  rocks.  Besides,  the  shore  air,  being  under 
more  pressure  than  at  high  altitudes,  contains  more 
oxygen  in  its  more  concentrated  form  of  ozone. 
And  the  effect  of  sunlight  on  animal  life,  when  not 
abnormally  intense,  is  directly  invigorating.  When, 
then,  with  this  is  combined  the  constant  inhalation 
of  salt  air,  and  salt  water  to  the  whole  body  in  the 

22 


INFANCY 

bathing  of  the  infant  and  child,  nothing  but  health- 
ful results  are  likely  to  be  forthcoming. 

DIET   OF   THE   NURSING   MOTHER 

The  diet  of  the  nursing  mother  should  at  all 
times  include  abundant  fluids,  in  order  that  the 
breast  secretion  may  be  active.  The  amount  of 
fluids  needed  is  much  larger  than  that  furnished 
by  the  ordinary  diet,  and  their  administration 
should  be  begun  as  soon  after  childbirth  as  the 
stomach  will  retain  them.  They  add  to  the  moth- 
er's comfort  and  flush  the  body,  through  the  kid- 
neys and  the  skin,  of  much  effete  matter  that  would 
otherwise  pass  into  the  mother's  milk,  disturbing 
the  child.  On  the  first  day  the  mother  should 
have  at  frequent  intervals,  water,  milk,  and  gruels, 
and,  if  necessary,  mutton  or  chicken  broth.  On  the 
second  day,  nutritious  fluids  and  simple  semi- 
solid foods.  On  the  third  day,  when  there  are  no 
complications,  digestible  solid  food  may  be  added. 
There  may  now  be  given  a  small  amount  of  meat 
once  a  day.  And  the  mother  should  eat  abundantly 
of  these  simple,  nutritious  foods  which  experience 
has  taught  she  can  comfortably  digest — milk,  eggs, 
meats,  cereals,  fruits,  and  green  vegetables.  Tea 
and  coffee  sparingly,  if  at  all;  they  are  stimulants 
which  have  no  milk-making  properties.  Tea,  es- 
pecially, may  disturb  the  mother's  digestion  and 
affect  the  child  untowardly  through  the  milk. 
Cocoa  is  excellent.  Beer  has  little  nutritive  value, 
and  this  and  other  alcoholic  beverages  are  pretty 
sure  to  disturb  the  infant.  Malt  extracts  have 
some  value,  chiefly  in  increasing  the  fat  in  the 

23 


WHY  DIE  SO  YOUNG? 

milk;  at  times  also  they  increase  the  flow  of  the 
milk.  At  least  one  quart  of  milk  should  be  drunk 
daily;  in  cases  of  faulty  digestion  it  may  be  given 
heated,  peptonized,  or  as  kumiss  and  other  fer- 
mented milks.  Corn  meal  gruel  has  no  equal  in 
restoring  deficient  secretion  of  breast  milk.  It 
should  be  cooked  at  least  four  hours  in  a  double 
boiler,  and  well  salted  to  taste,  thinned  with  water 
or  milk  so  that  it  can  be  drunk,  not  eaten  with  a 
spoon.  Two  or  three  bowlfuls  should  be  taken 
in  the  twenty-four  hours.  If  there  is  any  trouble 
in  digesting  it,  it  may  be  dextrinized.  The  latter 
is  done  as  follows:  Take  three-quarters  cupful 
of  yellow  corn  meal,  one  quart  cold  water,  two 
tablespoonfuls  cereo,  and  sufficient  salt  to  flavor; 
mix  in  a  double  boiler,  bring  slowly  to  a  boil 
(to  allow  the  cereo  to  act)  and  cook  for  two  or 
three  hours;  strain,  and  take  plain,  or  mix  with 
equal  parts  of  milk,  as  preferred. 

WEANING 

The  infant  is  weaned  about  the  twelfth  month; 
or  a  month  or  two  later,  in  the  cool  of  the  autumn 
if  it  has  attained  its  first  birthday  in  the  hot  summer. 
Cow's  milk  must  then  become  the  child's  chief 
pabulum.  It  has  become,  therefore,  the  earnest 
task  of  physicians,  municipal  authorities,  and 
philanthropists  to  secure  the  purest  possible  cow's 
milk  for  family  consumption.  Thus  in  some  cities 
milk  for  infants  is  required  to  be  certified.  Or  there 
are  specified  grades,  A,  B,  and  C,  the  first  grade 
only  being  proper  for  infants  and  little  children. 

And  like  methods  of  assuring  milk  purity  are  for- 

u 


INFANCY 

mulated  in  other  communities.1  Practically  all 
milk  intended  for  family  use  is  now  pasteurized. 
This  is  likely  to  become  a  process  universally  re- 
quired for  rendering  milk  a  safe  fluid. 

PURE   MILK 

No  one  who  could  afford  to  do  otherwise  should 
buy  loose  milk — that  is,  from  the  can,  or  taken  home 
in  pitchers.  Bottles  of  milk  should  be  wiped  or 
washed  as  soon  as  received  from  the  wagon  and 
placed  directly  in  the  refrigerator.  The  latter 
should  never  be  without  ice  nor  allowed  to  become 
warm.  Milk  should  at  all  times  be  covered  as  a 
protection  against  dust  and  insects.  It  should  be 
kept  in  some  part  of  the  ice  box  where  there  are 
no  strong-smelling  foods,  like  onions,  cheese,  or 
substances  from  which  odors  might  be  absorbed. 
The  object  of  such  precautions  as  these  is  to  keep 
the  milk  clean  and  to  retard  the  growth  of  germs 
in  this  fluid. 

"What  measures  are  necessary  to  safeguard  the 
purity  and  safety  of  milk?  (1)  The  cow  should 
be  healthy,  and  the  milk  of  any  animal  which  seems 
indisposed  should  not  be  mixed  with  that  from  the 
healthy  cows.  (2)  Cows  must  not  be  fed  upon 
swill,  or  the  refuse  from  breweries  or  glucose  fac- 
tories, or  upon  any  other  fermented  food.  (3) 
Milch  cows  must  have  access  to  fresh,  pure  water. 
(4)  The  pasture  must  be  kept  free  from  noxious 

1  Most  dairy  concerns  now  pasteurize  their  milk  before  vending  it. 
Or  this  can  very  easily  be  done  in  the  house  by  means  of  the  -Straus 
Pasteurizer,  which  can  be  bought,  if  not  in  a  hardware  store  or  depart- 
ment store,  of  the  Straus  laboratories  in  New  York  City,  at  a  reason- 
able charge. 

25 


WHY  DIE  SO  YOUNG? 

weeds,  and  the  barn  and  yard  must  be  kept  clean, 
(5)  The  udders  should  be  washed  and  then  wiped 
dry  before  each  milking.  (6)  The  milk  must  be 
at  once  thoroughly  cooled.  This  is  best  done  in 
the  summer  by  placing  the  milk  can  in  a  tank  of 
cold  water  or  ice  water,  the  water  being  of  the 
same  depth  as  the  milk  in  the  can.  It  would  be 
well  if  the  water  in  the  tank  could  be  kept  flowing; 
and  this  will  indeed  be  necessary  unless  ice  water 
is  used.  The  tank  should  be  thoroughly  cleaned 
each  day  to  prevent  bad  odors.  The  can  should 
remain  uncovered  during  the  cooling,  and  the  milk 
should  be  gently  stirred.  The  temperature  should 
be  reduced  to  60  degrees  F.,  or  lower,  within  an  hour. 
The  can  should  remain  in  cold  water  until  ready  for 
delivery.  (7)  The  milk  should  be  delivered,  during 
the  summer,  in  refrigerated  cans  or  bottles  about 
which  ice  is  packed  during  transportation.  (8) 
When  received  by  the  consumer  it  should  be  kept 
in  a  clean  place  and  at  a  temperature  below  60 
degrees  F. 

* 

BOTTLE   FEEDING   IS   UNNATURAL  FEEDING 

From  humankind's  beginning,  up  to  about  the 
middle  of  the  last  century,  infants  were  entirely 
breast  nurtured;  there  was  no  other  way.  Nothing 
could  have  been  more  of  an  eternal  verity  than 
this.  Some  mothers,  however  (and  the  exceptions, 
such  as  the  consumptive  mother,  were  very  rare, 
indeed),  could  not  and  cannot,  by  reason  of  disease 
or  other  abnormality,  fulfill  this  ideal  Madonna 
function.  And  it  was  in  behalf  of  those  mothers, 
thus  bereft  of  their  blessed  sex  right,  that  earnest 

26 


INFANCY 

physicians  and  chemists,  about  1850,  began  to 
seek  in  cow's  milk  some  adequate  approximation 
to  mother's  milk,  which  would  serve  somehow  to 
nourish  the  infant  during  the  first  year  of  its  ex- 
istence. An  ideal,  a  perfect  substitute  was  not 
hoped  for;  and  in  point  of  truth,  far  from  achieving 
any  such  substitute,  there  has  been  elaborated, 
during  all  these  sixty -odd  years,  not  even  an  ade- 
quate substitute.  I  believe  that  all  physicians 
especially  able  in  the  diseases  of  children  are  of 
this  opinion.  Nor  in  all  probability  will  there 
ever  be  such  a  substitute,  by  reason  of  the  insur- 
mountable difficulties  which  nature  has  put  in  the 
way  of  the  essay,  by  reason  of  the  irreconcilable 
differences  there  are  in  the  milk  of  various  living 
species. 

Wherefore  pediatrists  tell  us  that,  as  a  rule, 
bottle-fed  babies  get  their  teeth  later  than  those 
nurtured  on  the  breast — a  most  momentous  fact, 
since  teething  goes  -pari  passu  with  the  nervous 
system  (especially  brain  development),  with  speak- 
ing, with  jreeping,  and  walking.  The  former  infants 
are  prone  to  convulsions  and  to  such  aberrations 
from  health  as  are  likely  to  develop  later  in  life  into 
hysteria  and  other  nervous  disorders;  they  are 
listless,  sallow,  tending  to  weak-bloodedness  (by 
reason  of  their  calcium  starvation) ;  they  are  prone 
to  rickets;  they  need  far  more  air  space  than  nursing 
infants — as  much,  at  least,  as  do  adults,  because 
their  bodily  temperature  is  likely  to  be  below  the 
normal;  nor  are  their  organs  and  tissues  so  well 
developed.  And  they  are  more  prone  to  infectious 
disease  by  reason  that  no  substitute  milk  can  sup- 
ply certain  subtle  immunizing  principles  which  are 

27 


WHY  DIE  SO  YOUNG? 

inherent  in  mother's  milk.  Nor  is  it  possible  ever 
to  get  absolutely  germ-free  cow's  milk,  even  under 
the  most  favorable  circumstances. 

But  artificially  fed  infants  are  oftentimes  fat. 
So  are  beer  drinkers  fat — unhealthily  fat,  too.  An 
infant  fattened  on  artificial  food  may  be  actually 
starving  with  a  body  that  may  be  likened  "to  a 
large  showy  house  built  with  very  light  timbers, 
all  ready  to  collapse  under  the  slightest  strain." 

These  things  and  many  more  to  the  same  effect 
do  earnest  and  anxious  children's  doctors  tell  us. 
Think  of  it!  Twenty  times  as  many  bottle-fed 
babies  than  breast  fed  are  prone  to  the  "summer 
complaints"  and  the  dysenteries;  among  the  former 
ten  times  as  many  such  pitiful  little  sufferers  die. 
During  the  first  year  of  their  helpless  lives  three 
times  as  many  die  of  the  various  diseases  to  which 
infancy  is  subject.  In  a  comparative  study  made 
in  one  city,  a  very  small  percentage  of  those  who 
had  in  infancy  been  artificially  fed  were  found  alive 
after  their  twenty-first  year.  Dr.  Thomas  South- 
worth,  so  devoted  and  so  able  in  pediatrics,  has 
stated,  before  a  medical  society,  that  nowadays 
60  per  cent,  of  all  mothers  cannot,  or  think  they 
cannot,  or  are  led  to  imagine  that  they  cannot, 
or  just  crassly  and  obstinately  will  not,  yield  to  the 
yearning  of  the  infant,  with  no  language  but  a 
cry,  for  the  breast  of  the  mother  who  bore  it.  Such 
a  mother  bewailed  to  a  great  physician — whose 
temperament  was  a  trifle  short  as  to  diplomacy — 
that  it  had  pleased  Providence  to  take  her  infant 
from  her.  He  told  her  bluntly  that  she  had  no 
right  nor  reason  to  lay  the  blame  on  Providence. 
Providence  had  had  nothing  at  all  to  do  with  the 

28 


INFANCY 

wretched  business.  It  was  not  the  Deity,  but  her 
own  abominable  perversity,  aided  and  abetted  by 
bad  milk,  that  had  killed  her  baby.  And  yet  there 
are  people  so  blind,  iso  fatuous  as  to  expect  that 
this  twentieth  century  of  ours  is  going  to  evolute 
a  super  race!  Think  deeply  for  a  moment  of  the 
relation  in  which  maternal  nursing  stands  to  the 
welfare  and  the  future  of  our  kind.  The  mother's 
organism  is  in  the  most  intimate  union  with  that 
of  her  infant.  The  normal  exercise  of  the  nursing 
function  does  indeed  not  only  develop  the  infant 
normally,  but  the  fortunate  mother  as  well  and  as 
beneficently,  emotionally,  spiritually,  intellectu- 
ally, in  every  possible  way  that  is  natural  and  ra- 
tional. And  all  this  through  the  warmth  and  the 
close  bodily  contact,  the  caresses,  and  the  constant 
play  of  mother  and  child,  the  tiny  hand  creeping 
confidently  about  the  mother's  neck.  Who  can, 
who  dare  estimate  the  part  played  in  the  molding 
of  the  child's  character,  to  the  infinite  benefit  of 
the  individual  and  of  the  race,  by  the  sweetness 
of  the  mother's  smile,  which  her  infant's  first 
visual  impressions  receive,  by  the  comfortableness, 
the  lovingness,  the  cherishing,  expressed  in  the 
maternal  countenance? 

A   PRECIOUS   POSSESSION 

And  what  possession  has  a  really  human  mother 
more  precious  than  the  babe  at  her  breast;  what 
more  dreadful  to  such  a  mother  than  its  loss? 
There  is  a  picture — everybody  has  seen  it  in  print 
shops — representing  a  young  mother  of  the  poor, 
clad  in  a  cheap  shawl,  weeping  over  the  corpse  of 

29 


WHY  DIE  SO  YOUNG? 

her  firstborn.  I  have  myself  seen  that  picture  in 
the  very  life — and  death — a  haunting  memory  in- 
deed. It  was  in  a  squalid  tenement.  There  was 
nothing  in  the  room  save  a  kitchen  table  on  which 
the  dead  baby  lay;  and  close  to  the  table  was  a 
rickety  chair  on  which  the  mother  sat.  Absolutely 
nothing  else. 

I  had  knocked  several  times  at  the  door  and  had 
received  no  answer.  Then  I  went  in.  Just  as  in 
the  painting  sat  the  young  mother,  hugging  that 
rigid  little  body,  its  baby  head  so  endearingly 
shaped,  constantly  kissing  its  thin,  waxen  hands, 
crying  convulsively  so  that  the  tears  ran  down  her 
cheeks  and  upon  her  baby's  face,  while  she  talked 
to,  even  crooned  to,  the  little  creature  she  had 
borne,  for  which  she  had  so  willingly  suffered; 
cuddling  it  to  her  breast  and  begging  it  to  smile, 
as  she  had  coaxed  it  to  in  the  life,  doing  the  things 
good  mothers  love  to  do  with  their  infants.  The 
tragedies  of  the  ancient  Greeks  and  all  others  im- 
agined since  paled  in  significance  before  the  one 
before  me,  while  I  stood  speechless,  reverential, 
and,  to  speak  truthfully,  frightened.  And  I  turned 
away  unnoticed,  and  left  the  room,  closing  the 
door  upon  that  profoundest  and  most  mysterious 
of  all  human  tragedies. 


n 

CHILDHOOD 

"Then  the  whining  schoolboy,  with  his  satchel 
And  shining  morning  face,  creeping  like  snail 
Unwillingly  to  school." 

THE  UNIVERSAL  PARAMOUNT 

I  NOW  beg  to  introduce  the  most  important  sub- 
ject in  the  universe,  barring  none.  By  giving  it 
the  respect  to  which  its  momentous  nature  entitles 
it,  by  maintaining  the  standards  it  connotes,  the 
superman  and  the  superwoman  will  be  assured, 
most  of  the  physical  evils  suffered  by  mankind 
will  be  abolished;  and  since  practically  all  the 
world's  miseries  come  about  by  reason  of  individual 
departures  from  the  normal,  most  of  the  dreadful 
perversities  we  read  of  every  day  in  our  news- 
papers will  disappear,  along  with  the  need  of  courts 
— children's  courts,  domestic  relations  courts,  crim- 
inal courts;  and  life  from  the  beginning  to  its  end,  a 
century  or  near  a  century  off,  would  be  for  all  of  us, 
anyway  for  most  of  us,  just  one  grand,  sweet  song ! 
I  am  of  course  referring  to  baby's  right,  normal 
and  healthy  development  from  its  birth  up  to  its 
fortieth  month.  This  assured,  the  baby,  thus 
hardened  and  rendered  resistant  to  evil,  both  as  to 
its  mind  and  to  its  body,  is  likely  to  journey  along 
life's  path  not  in  sorrow  and  in  travail,  but  safely 

31 


WHY  DIE  SO  YOUNG? 

and  pleasantly  (tute  et  jucunde,  as  the  physicians 
of  another  generation  used  to  say),  until  it  reaches 
its  second  childhood,  at  least.  And  if  this  is  not 
the  most  important  subject  in  existence,  I  would 
be  obliged  to  any  philosopher,  political  economist, 
socialist,  feminist,  or  mere  man  on  the  street,  who 
could  convince  me  that  there  is  one  more  so.  Let 
us,  then,  consider  baby's  development,  month  by 
month,  beginning  with  the  first  so  pathetic  and  so 
momentous  cry  by  which  it  takes  into  its  several 
pounds  of  body  the  physical  breath  of  life. 

First  month:  Baby  is  sensitive  to  light  the  first 
or  second  day;  about  the  eleventh  day  it  takes 
pleasure  in  candlelight  and  in  bright  objects;  the 
fourth  day  it  hears;  during  the  second  fortnight  it 
discriminates  sounds;  it  starts  at  gentle  touches 
the  second  and  third  days;  it  shows  sensibility  to 
taste  about  the  end  of  the  first  week;  strong- 
smelling  substances  produce  mimetic,  grimacing 
movements  of  the  face  the  first  day;  during  the 
first  few  days  it  evinces  pleasure  in  nursing,  in 
its  bath,  in  the  sight  of  agreeable  objects;  on  the 
other  hand,  it  can  evidence  discomfort  from  cold, 
wet,  and  tight  clothing,  nor  can  any  words  be  more 
unmistakable  nor  more  eloquent  than  the  expres- 
sion of  its  sense  of  outrage  by  reason  of  delayed 
alimentation;  on  the  twenty-third  day  it  can  ex- 
hibit tears;  on  the  twenty-sixth  day — mark  that 
blessed  date  in  the  calendar — it  smiles;  within  the 
first  month  it  can  utter  vowel  sounds;  the  memory 
as  to  taste  and  smell  is  first  active,  then,  in  order, 
come  touch,  sight,  and  hearing;  the  movements  of 
the  eyes  are  not  as  yet  co-ordinated,  and  no  mother 

need  worry  at  this  time  if  there  is  squint;  the  re- 

3i 


CHILDHOOD 

flexes  begin  to  be  active;  baby  sleeps  two  hours  at 
a  time  and  sixteen  out  of  the  twenty -four.  Thus 
far  sleep  and  pabulum  make  up  its  main  interest  in 
the  universal  scheme  in  which  it  will  later  play 
so  important  a  part. 

Second  month:  Squint  is  occasional  until  the 
end  of  the  month;  baby  now  recognizes  human 
voices,  turns  its  head  toward  sounds,  is  pleased 
with  music  and  with  human  faces  in  general;  sleeps 
three,  sometimes  six  hours  at  a  stretch;  laughs 
from  tickling  at  eighth  week;  clasps  with  its  fore- 
fingers at  eighth  week;  first  consonants  about  the 
fiftieth  day,  as  am-ma,  ta-hu,  gooo,  ara. 

Third  month :  Cry  of  joy  at  sight  of  mother  and 
father,  about  sixtieth  day;  eyelids  not  completely 
raised  when  it  looks  up ;  accommodates  its  eyesight 
to  light  and  distance  at  ninth  week;  notes  the  tick- 
ing of  a  watch  at  ninth  week;  listens  with  absorbed 
attention. 

Fourth  month:  Eye  movements  are  perfect; 
objects  seized  are  moved  toward  the  eyes;  grasps 
at  objects  too  distant;  enjoys  seeing  itself  in  mir- 
ror (girl  babies  exhibit  this  phenomenon  earlier 
than  do  boy  babies);  can  grasp  with  thumb  and 
contrapose  to  hand  at  fourteen  weeks;  can  hold 
up  head  by  itself;  sits  with  back  supported  at  four- 
teenth week;  begins  to  imitate. 

Fifth  month:  Discriminates  strangers;  looks  in- 
quiringly; takes  pleasure  in  crumpling  and  tearing 
newspapers;  rings  a  bell  with  zest;  likes  to  pull  hair; 
has  been  known  to  pretty  nearly1,  if  not  altogether, 
eviscerate  an  adult  ear,  or  uproot  a  mustache; 
can  sleep  ten  to  twelve  hours  without  food;  desire 
shown  by  stretching  out  hands  and  arms;  seizes 

33 


WHY  DIE  SO  YOUNG? 

and  carries  objects  to  mouth;  enlarges  its  vocabu- 
lary with  the  consonants  I  and  k. 

Sixth  month:  Raises  itself  into  sitting  posture; 
laughs  and  raises  itself  and  drops  arms  when 
pleasure  is  great;  crows  with  pleasure;  compares 
image  of  father  with  original. 

Seventh  month:  Astonishment  shown  by  open 
mouth  and  eyes;  recognizes  nurse  after  four  weeks 
absence;  sighs;  imitates  movements  of  head  and  of 
pursing  lips;  averts  head  as  sign  of  refusal;  places 
itself  upright  on  the  lap. 

Eighth  month:  Is  astonished  at  new  sounds  and 
sights  at  imitations  of  cries  of  animals. 

Ninth  month:  Stands  without  support;  shows 
increasing  interest  in  things  in  general  or,  in  evo- 
lutionary parlance,  begins  to  get  in  touch  with  its 
environment;  strikes  hands  with  joy;  shuts  eyes 
and  turns  head  away  when  something  disagreeable 
is  to  be  endured;  fears  a  dog;  turns  over  when  laid 
face  downward;  turns  head  to  light  when  asked 
where  it  is;  understands  questions  before  it  can 
speak;  its  voice  becomes  more  modulated,  though 
losing  none  of  its  potency  or  carrying  power. 

Tenth  month:  Sits  up  without  support  in  bath 
and  carriage;  first  attempts  at  walking  in  forty -first 
week;  beckoning  imitated;  misses  parents  in  their 
absence;  will  miss  a  single  ninepin  in  a  set;  cannot 
yet  repeat  a  syllable  heard,  but  exhibits  no  little 
talent  as  a  monologist,  as:  Maa,  pappa,  tatta, 
apappa,  baba,  tataa,  rrrrrr  rrrrraa. 

Eleventh  month :  Screaming  is  quieted  by  "  Sh  " ; 
sitting  becomes  a  habit;  stands  without  support; 
stamps;  repeats  syllables  correctly;  begins  to  whis- 
per; enlarges  its  vocabulary;  can  utter  b,  p.  t,  d,  m, 

34 


CHILDHOOD 

n,  r,  I,  g,  k;  vowel  a  most  used;  u  and  o  rarely;  % 
very  rarely. 

Twelfth  month:  Pushes  chair;  cannot  as  yet 
raise  itself  or  walk  without  help;  obeys  the  com- 
mand, "Give  me  your  hand." 

Thirteenth  month:  Creeps;  shakes  head  in  de- 
nial; says  "papa"  and  "mama";  understands 
some  spoken  words. 

Fourteenth  month:  Can  walk  without  support; 
raises  itself  by  chair;  imitates  coughing  and  swing- 
ing of  arms. 

Fifteenth  month :  Walks  without  support;  laughs, 
smiles,  gives  a  kiss  by  request;  repeats  syllables; 
understands  ten  words. 

Sixteenth  month:    Runs  alone;  falls  rarely. 

Seventeenth  through  nineteenth  month:  Sleeps 
ten  hours  consecutively;  associates  words  with  ob- 
jects and  movements;  blows  horn;  strikes  with 
hand  or  foot;  waters  flowers;  puts  stick  of  wood 
in  stove;  washes  hands;  combs  and  brushes  hair, 
with  other  imitative  movements. 

Twentieth  to  twenty-fourth  month :  Marks  with 
pencil  on  paper;  whispers;  executes  orders  with 
surprising  accuracy;  dances  to  music;  likes  to  sing 
and  beat  time. 

Twenty-fifth  to  thirtieth  month:  Distinguishes 
colors  correctly;  makes  sentences  of  several  words; 
begins  to  climb,  jump,  and  ask  questions. 

Thirty -fifth  to  fortieth  month:  Goes  upstairs 
without  help;  applies  sentences  correctly;  forms 
clauses;  speaks  words  distinctly,  but  the  influence 
of  dialect  is  apparent;  approximates  its  manner  of 
speech  more  and  more  to  that  of  the  family;  ques- 
tions and  questions  and  questions  until  the  fond 

35 


WHY  DIE  SO  YOUNG? 

parent  is  like  to  succumb  to  psychasthenia,  if  not 
prematurely  to  senile  dementia. 

The  parent,  by  comparing  this  schedule  of  the 
ordinary,  the  average  child's  development  with  that 
of  his  or  her  own  will,  of  course,  find  the  latter  far 
the  more  advanced.  Possibly,  however,  there  may 
appear  here  and  there  traits  a  trifle  backward. 
But  such  backwardness  has  frequently  been  ob- 
served in  infants  which  later  in  life  have  developed 
normally  enough  and  with  perhaps  more  sure  and 
solid  growth  than  the  ordinary.  And  yet,  if  there 
are  any  definite  departures  from  the  normal  as  to 
sensations,  perceptions,  ideation,  and  speech,  it 
would  be  well  to  draw  these  to  the  family  doctor's 
attention,  so  that  right  development  may  be  se- 
cured without  delay. 

THE   HEALTHFUL  HOME 

Something  now  as  to  the  home  in  which  the 
child  is  to  be  brought  up. 

It  is  not  so  much  money  as  it  is  intelligence  and 
determined  action  that  make  for  safe,  sanitary, 
wholesome  dwellings,  housing  contented  and  healthy 
families. 

The  first  consideration  in  choosing  a  home  should 
be  as  to  its  salubrity;  convenience  and  other  items 
should  be  secondary.  Especially  to  be  chosen  is 
a  locality  where  pure  air  and  sunshine  can  be  had, 
where  there  is  no  marsh,  no  damp  cellar  or  bad 
smell.  Pure  water  must,  above  all,  be  assured. 
When  Abraham  went  down  to  live  among  the 
Philistines  his  first  step  was  to  dig  a  well;  before 
everything  else  he  provided  that  he  and  those  for 

36 


CHILDHOOD 

whose  lives  he  held  himself  responsible  should  have 
an  abundance  of  pure  drinking  water. 

Sunshine  colors  the  cheeks  of  children  as  surely 
as  it  does  the  skins  of  apples.  It  shows  up  dirt, 
so  that  frequent  cleansing  is  necessary.  And  with 
fresh  air,  it  is  the  best  of  all  disinfectants,  destroy- 
ing the  dirt  the  mother  cannot  see,  the  microscopic 
dirt — that  is,  the  disease  germs.  Sunshine  and 
sanitation  go  ever  hand  in  hand.  Sunshine  saves 
fuel,  too.  Rugs,  by  reason  that  they  can  be  fre- 
quently renovated,  should  be  substituted  for  carpets. 

We  make  laws  for  factories,  shops,  schools,  and 
lodging  houses  with  regard  to  fresh  air,  ventilation, 
the  amount  of  space  for  each  occupant.  Are  we 
going  to  do  any  less  for  our  children  than  the  police 
enforce  in  behalf  of  the  lodging-house  vagrant? 

Other  vital  home  sanitation  matters  are  drainage, 
plumbing,  the  disposal  of  garbage  and  of  domestic 
waste,  dust,  insect  enemies,  ventilation,  kitchen 
and  other  arrangements. 

Having  moved  into  a  healthful  home,  the  average 
citizen  needs  to  inform  himself  about  ordinary 
sanitation,  and  that  sufficiently  to  avoid  for  his 
family  the  risks  of  suffering  and  disease.  The  best 
homes  speedily  become  unheal thful  if  their  inmates 
are  unclean  in  their  personal  habits.  Unless  the 
question  of  cleanliness  is  courageously  dealt  with  in 
families,  by  sanitary  authorities  and  by  legal  methods, 
no  great  headway  can  be  made  in  securing  the  prime 
need  of  our  time,  healthful  housing  conditions. 

THE   AIR   WE   BREATHE 

A  plenitude  of  pure  air  is  essential  to  right 
living,  from  the  cradle  to  the  last  respiration.    For 

4  37 


WHY  DIE  SO  YOUNG? 

weeks  we  may  live  without  food,  days  without 
drink;  but  no  more  than  a  minute  or  two  without 
oxygen,  the  essential  ingredient  of  air.  This  life- 
maintaining  gas,  when  combined  with  food  and 
water,  makes  heat;  and  that  is  why  the  sentient 
body  is  generally  warmer  than  the  atmosphere. 
All  animal  and  vegetable  life  depends  on  oxygen. 
Under  the  sun's  benignant  influence  plants  give  out 
this  gas,  which,  thus  freed,  is  respired  by  animal 
life.  Our  blood  capillaries  carry  it  to  our  organs, 
to  our  uttermost  tissues  and  cells;  and  thus  do  we 
receive  power  and  warmth  and  health — in  fact,  life 
itself.  The  Almighty  "  breathed  into  his  nostrils 
the  breath  of  life,  and  man  became  a  living  soul." 

Every  room,  therefore,  in  the  home,  living  and 
sleeping  rooms  alike,  should  be  thoroughly  venti- 
lated. Air  motion,  its  coolness,  purity,  and  fresh- 
ness, with  a  moderate  degree  of  humidity,  are  the 
essentials. 

A  gentle  draft  should  always  be  aimed  for; 
Nature  generally  arranges  for  the  right  cross 
currents  outdoors.  And  we  would  have  them 
naturally  in  our  houses  if  we  but  allowed  her  freedom 
of  action  by  opening  wide  our  windows  all  the  time 
in  temperate  weather,  and  some  of  the  time,  at  least, 
in  very  inclement  weather.  A  strong  draught  is 
deleterious  to  the  health  of  the  most  of  us,  cave 
dwellers  as  we  are;  those  inured  to  draughts  suffer 
no  harm  from  them.  A  famous  physician  who  had 
achieved  his  cure  from  the  tuberculosis  he  had  suf- 
fered, while  visiting  a  college  where  he  was  to  give 
a  lecture,  sat  in  his  shirt  sleeves  before  an  open 
window  on  a  very  cold  night,  welcoming  the  blasts, 
until  one  by  one  his  entertainers,  abjuring  their 

38 


CHILDHOOD 

host  duties,  left  him  in  ultimate  and  magnificent 
isolation. 

Moderate  coolness  of  the  air  is  most  desirable. 
Air  in  motion  is  cooler  than  stagnant;  at  any  rate, 
it  seems  so.  Pure  air  is  as  dust  smoke  and  germ 
free  as  possible.  Fresh  air  is  changed  air;  air  that 
is  constantly  rebreathed  soon  becomes  poisonous. 
And  indoor  air,  by  the  way,  is  not  necessarily  pure 
because  it  is  cold.  In  the  wintertime  house  air 
is  likely  to  be  unduly  dry.  A  moderate  amount  of 
moisture  is  salutary  and  may  be  attained,  to  some 
extent  at  least,  by  heating  water  in  large  pans  or 
in  open  vessels. 

To  have  rooms  constantly  supplied  with  fresh 
air  there  should  be  an  arrangement  by  which  oxygen 
from  outdoors  is  supplied  all  the  time.  A  current 
from  room  to  room  will  not  suffice.  Stoves,  cer- 
tainly in  bedrooms,  are  pernicious,  being  ravenous 
of  oxygen  and  often  emitting  gases  which  result 
from  imperfect  combustion. 

An  open  grate  or  a  register  may  afford  sufficient 
current.  We  may  raise  the  lower  sash  of  one 
window  several  inches — never  less  than  one  inch — 
and  lower  the  upper  part  of  a  window  adjacent. 
Or  the  window  board  is  advisable.  The  edge  of 
this  board  rests  on  the  edge  of  the  window  sill, 
the  ends  being  attached  firmly  to  the  window 
frame.  This  affords  a  vertical  surface  three  or 
four  inches  high  and  situated  three  or  four  inches 
in  front  of  the  window,  so  as  to  deflect  the  cold 
air  upward  when  the  window  is  slightly  opened. 
It  is  considered  that  the  air  will  then  reach  the 
breathing  zone  instead  of  flowing  on  to  the  floor  and 
chilling  the  feet. 


WHY  DIE  SO  YOUNG? 

There  should  be  a  current  in  the  sleeping  room 
all  night  long;  and  there  will  never  be  a  night  so 
cold  that  this  could  not  be  done.  We  could  raise 
the  lower  sash  six  inches  and  fit  a  board  beneath 
it,  so  that  air  will  pass  between  the  sashes.  Dust- 
excluding  nets,  and  like  contrivances,  are  made 
cheaply  to  fit  into  these  spaces.  The  indoor  temper- 
ature should  be  between  sixty  and  seventy  degrees, 
never  more  than  the  latter;  at  night  it  should  be 
much  lower.  Of  course,  draughts  should  be  avoided 
until  one  becomes  accustomed  to  them;  this  can 
be  done  by  means  of  screens  or  blankets  hung  up. 
There  will  be  no  draughts  when  the  air  comes  from 
one  side  only. 

PURE  WATER 

The  best  drinking  water  is  such  as  comes  down 
to  us  in  springs  and  rills  from  the  hilltops, 
sparkling,  cascading,  silvering  in  the  sunshine,  and 
taking  up  in  its  passage,  from  the  rocks  and  the 
soil  through  which  it  flows,  the  gases  that  make  it 
the  most  delicious  beverage  ever  invented.  But 
water  supplies  have  been  known  to  come,  in  part 
at  least,  from  contaminated  sources;  and  there 
have  been  cases  in  which  the  old  oaken  bucket, 
the  babbling  brook,  and  the  sylvan  springs  of  the 
poet  have  occasioned  some  very  prosaic  suffering 
and  death  from  typhoid  fever  and  like  ingestion 
infections. 

Of  course,  it  is  the  duty  of  governments — town, 

city,  and  state — to  keep  water  supplies  pure  and 

germ-free;  but  every  one  knows  of  places  and  times 

in  which  this  function  has  been  cruelly  neglected. 

In  many  localities  householders  must  still  do  what 

40 


CHILDHOOD 

they  can  for  themselves  and  their  children,  to  keep 
their  drinking  water  wholesome. 

Boiling  water  will  make  all  the  germs  in  it  harm- 
less, though  it  may  remain  as  muddy  as  ever. 
From  the  sanitation  viewpoint,  the  latter  is  not 
objectionable,  but  boiled  water  is  insipid,  because 
all  the  natural  gases  that  make  Adam's  ale  so 
precious  a  drink  bubble  out  in  the  boiling.  The 
palatability  of  boiled  water  can  be  restored  by 
aerating  it;  water  is  also  purified  by  distillation 
followed  by  aeration. 

When  and  where  there  are  epidemics  of  water- 
born  diseases  and  no  guaranteed  system  of  water 
filtration  exists,  the  water  for  drinking  and  cooking 
purposes  must,  for  the  average  citizen,  be  boiled 
(with  or  without  aeration),  or  passed  through 
domestic  filters  of  assured  efficiency.  The  most 
perfect  of  domestic  filters  are  only  making  the 
best  of  a  bad  state  of  things.  The  small  sand, 
animal-charcoal,  wire-cloth,  filter-paper,  sponge, 
and  cotton  contrivances  which  are  screwed  on  to 
the  faucet  and  which  let  much  water  pass  rapidly 
through  them,  are  not  filters  at  all,  but  simply 
strainers,  which  give  a  murderously  false  sense  of 
security. 

Hypochlorite  of  lime  (calcium;  will  sterilize  water 
and  make  it  safely  potable,  though  it  will  not  re- 
move turbidity  or  queer  odors — which  latter  are 
best  removed  by  filtration,  and  are,  in  any  event, 
harmless.  Our  government  at  Washington  has  per- 
fected for  our  soldiers  an  arrangement  by  which 
the  smallest  convenient  amount  of  calcium  hypo- 
chlorite (1  gram,  15  grains)  is  hermetically  sealed 
in  a  glass  tube  about  the  size  of  a  fountain  pen, 

41 


WHY  DIE  SO  YOUNG? 

so  that  the  chlorine,  the  sterilizing  element  in  the 
compound,  will  remain  active  and  potent  for  at 
least  ten  months,  if  kept  in  the  dark,  and  at  a 
moderate,  ordinary  temperature.  The  specifica- 
tions call  for  a  chlorine  content  of  30  to  32  per 
cent.  Such  a  tube  can  be  prepared  by  any  chemist, 
and  should  be  obtainable  for  domestic  use  of  most 
druggists  at  a  cost,  for  the  material,  of  about  five 
cents. 

The  contents  of  such  a  tube  should  sterilize  from 
forty  to  sixty  gallons  of  water.  Of  course,  water 
used  for  cooking,  being  boiled,  need  not  be  thus 
treated;  only  that  for  drinking.  The  tube  is  easily 
split,  at  the  point  marked,  by  a  file.  The  contents 
may  be  shaken  directly  on  the  surface  of  the  water, 
or  it  may  be  added  to  a  small  cup  of  water  and  then 
poured  directly  into  the  large  container.  No  stir- 
ring is  necessary.  The  water  is  rendered  typhoid, 
dysentery,  and  cholera  safe  in  five  minutes;  but 
thirty  minutes  will  assure  a  100-per-cent  bacteri- 
cidal efficiency.  A  water  supply  thus  treated  will 
continue  potable  for  ten  days. 

FOOD 

Next  in  importance  after  air  and  water  comes 
food. 

Food  is  material  which  supplies  energy  for  the 
bodily  activities,  which  enters  into  its  structure, 
and  which  so  regulates  the  vital  processes  as  to  pro- 
duce and  maintain  health. 

Calories  represent  the  energy  vahie  of  food  and 
the  energy  requirements  of  our  bodies.  One  adult's 
requirements  vary  from  2,300  to  3,500  calories  the 

42 


CHILDHOOD 

day — less  for  the  desk  worker,  more  for  the  manual 
laborer. 

Vitamines  are  substances  existing  in  whole-grain 
cereals,  fruits,  vegetables,  brown  rice,  milk,  etc. 
They  are  essential  for  the  growth  and  the  regula- 
tion of  the  bodily  processes.  They  are  found  in 
cereals  and  vegetables  in  or  near  the  husk  or  skin; 
hence  the  importance  of  not  wasting  those  essential 
food  parts. 

Protein  is  the  foodstuff  necessary  for  building 
the  muscular  tissue.  It  abounds  in  lean  meat, 
milk,  white  of  egg,  wheat,  cheese,  beans,  etc. 
Protein  also  furnishes  heat  and  energy,  but  not  to 
so  great  extent  as  the  carbohydrates  and  fats. 

Carbohydrates  are  starches  and  sugars;  they  are 
found  mostly  in  cereals,  vegetables,  and  fruits. 

Fats  are  found  in  butter,  cream,  oils,  and  bacon; 
they  also  supply  energy  and  heat.  An  excess  of 
them   helps   for  an   energy   reserve  in   the  body. 

Under  Appendix  A  will  be  found  the  right  dietary 
for  a  child  from  the  time  of  weaning  on. 

HARDENING 

In  our  concern  for  the  right  development  of 
child  life  do  not  let  us  fall  into  the  error  of  the 
naturalist  who,  while  studying  the  difficulty  a  butter- 
fly has  in  breaking  from  the  chrysalis,  determined  to 
help  along  its  will-to-live  by  cutting  through  some 
impediments  it  had  to  contend  with,  so  that  it  could 
the  more  easily  free  itself.  And  what  had  that 
unusually  tender-hearted  scientist  accomplished  by 
his  helping?  Instead  of  coming  out  strong  and 
beautiful,  the  butterfly  was  a  frail  thing  indeed. 

43 


WHY  DIE  SO  YOUNG? 

The  struggle  of  which  mistaken  kindness  had  re- 
lieved it  was  the  very  source  of  the  strength  of 
body  and  the  iridescence  of  wing  it  should  have 
begun  life  with.  Ducklings  also  that  are  helped 
from  their  shells  differ  from  those  which  just  have 
to  struggle  out,  in  being  stunted  and  puny,  if  indeed 
they  do  not  die  at  once,  or  soon  after  the  too  kindly 
hand  had  helped  them  out  of  the  egg-shell  stage  of 
their  development. 

Dr.  Abraham  Jacobi,  who  recently  passed  away 
at  eighty-nine,  the  Nestor  of  American  Medicine, 
and  whose  special  life  work  was  in  children's  dis- 
eases, was  very  insistent  on  the  hardening  of  the 
infant  and  the  child;  and  he  left  directions  to  this 
end  which  I  here  epitomize: 

What  is  meant  by  hardening?  Nothing  but  this; 
that  the  resistance  of  the  child  to  the  effect  of  ex- 
ternal influences  should  be  strengthened.  Is  there 
a  uniform  method  applicable  to  every  child,  no 
matter  of  what  age  or  constitution?  Certainly  not; 
but  there  is  one  object  which  should  be  accomplished 
for  every  infant  and  child — the  invigoration  of  ex- 
ternal circulation.  The  surface  of  a  child  from  two 
to  ten  years  measures  from  three  to  ten  square 
feet.  In  and  under  the  surface  there  is  a  lake  of 
blood.  In  vigorous  health  this  blood  is  in  constant 
and  rapid  circulation.  Within  two  minutes  it  en- 
ters and  leaves  the  surface,  comes  from  and  leaves 
the  center  of  circulation,  the  heart.  Slow  circula- 
tion in  the  surface  retards  the  flow  of  blood  in  the 
whole  body  and  impairs  nutrition  of  the  heart  and 
of  every  organ,  causing  congestion,  insufficient 
function,  and,  in  time,  disease.  Rapid  circulation 
in  and  under  the  skin,  causing  rapid  circulation 

44 


CHILDHOOD 

elsewhere,  propels  the  totality  of  blood  in  the 
child's  body  (from  two  to  six  pounds,  according  to 
age — from  two  to  twelve  years)  into  and  through 
the  lungs,  in  which  the  contact  with  and  the  ab- 
sorption of  the  oxygen  in  the  atmosphere  takes 
place.  Now  the  best  stimulant  of  the  circulation 
in  general  is,  besides  muscular  action — exercise — 
the  stimulation  of  the  skin  by  friction  and  cold 
water.  A  child  of  two  or  three  years  should  have 
a  daily  cold  wash,  either  after  a  warm  bath,  or 
standing  in  cold  water  which  covers  the  feet,  or 
lying  on  the  attendant's  lap,  or  on  a  mattress.  A 
brisk  rubbing  with  a  wet  towel  one  or  two  minutes, 
and  with  a  dry  towel  until  the  surface  is  dry  and 
warm,  is  sufficient.  Older  children  may  have  a 
wet  sponge  squeezed  out  over  them,  this  procedure 
being  followed  by  the  same  effective  friction;  or 
they  may  be  plunged  into  cold  water — in  the  winter 
a  single  moment,  in  the  summer  several  minutes. 
While  in  any  bath  the  skin  should  be  thoroughly 
rubbed.  This  rule  must  not  become  a  routine,  or 
applicable  to  every  child.  Cold  water  and  friction 
require  a  healthy  heart  and  a  certain  degree  of 
strength.  They  only  facilitate  the  reaction  that 
should  be  looked  for  in  every  instance.  The  same 
healthy  child,  when  taken  sick  or  when  convales- 
cent from  a  disease,  lacks  the  necessary  vigor,  and 
the  routine  must  be  interrupted.  A  child  under 
size  and  under  weight  requires  warmer  water  and 
friction.  That  is  why  a  newly  born  baby  or  an 
infant  of  less  than  one  or  two  years  should  be  spared 
a  low  temperature.  That  is  why,  also,  a  child  whose 
feet,  after  a  bath  or  washing,  do  not  get  so  warm 
as  the  rest  of  the  body,  should  be  rubbed  down,  not 

45 


WHY  DIE  SO  YOUNG? 

with  cold,  but  with  warm  water,  or  with  an  equal 
mixture  of  alcohol  and  water,  until  the  constitution 
is  gradually  improved  and  fortified. 

Adenoids  and  enlarged  tonsils  we  shall  presently 
consider.  Sleeping  children  must  have  plenty  of 
air;  sleeping  garments  of  the  grain-bag  construction 
may  be  provided  for  those  who  kick  their  bed- 
clothes off.  All  heart  and  lung  affections  should, 
if  possible,  be  nipped  in  the  bud  or  coped  with 
in  their  weedy  incipiency.  Children  convalescent 
from  diphtheria,  whooping  cough,  measles,  and  the 
like,  should  be  carefully  nurtured  and  sent,  if  pos- 
sible, from  town — to  the  seashore  preferably,  or  to 
rural  districts,  until  they  are  fully  restored.  Acci- 
dents involving  bones  and  joints  should  cause 
peculiar  anxiety,  because  tuberculosis  all  too  often 
results  from  such  hurts.  All  young  structures  are 
less  firm,  less  organized,  and  more  vulnerable  to 
disease  than  those  of  adults.  The  child  must  as 
early  as  possible  be  taught  not  to  swallow  its  nose 
and  throat  excretions;  these  latter  are  frequently 
germ-laden,  and  may  thus  engender  intestinal  tuber- 
culosis, infantile  paralysis,  and  other  infections. 

THE   SCHOOL   CHILD 

"Give  a  child  in  my  keeping,  put  it  under  my 
influence  up  to  its  sixth  year,  and  though  you  may 
then  take  it  from  me  forever,  though  I  may  never 
see  its  face  again,  I  shall  be  content.  For  it  will 
throughout  its  life  and  to  its  dying  day  abide 
steadfast  by  the  training  I  have  given  it."  If  the 
religious  teacher  who  spoke  thus  had  doubled  this 
formative  period,  the  child  would  of  a  certainty 

46 


CHILDHOOD 

not  depart  from  the  path  laid  out  for  it  during 
those  dozen  years.  I  believe  the  principle  is  tre- 
mendous; and  of  most  vital  consideration  in  this 
most  chaotic  twentieth -century  civilization  of  ours, 
when  all  evil  is  supposed  to  be  avoided  and  rectified 
by  laws  or  through  paternalism  (governmental  or 
otherwise)  rather  than  through  reverence  for  the 
home  and  for  the  family  ideal.  The  first  dozen 
years  are  the  most  impressionable  in  human  ex- 
istence; which  means  that  the  child's  destiny  is 
developed  essentially  in  the  home,  and  that  it 
were  well-nigh  hopeless  to  assure  its  right  develop- 
ment anywhere  else. 

Of  course,  the  school  and  the  religious  teacher 
must  play  their  adjuvant  part.  Childhood  is  the 
formative  period  for  both  the  mind  and  the  body. 
The  ancients  were  right  in  insisting  on  the  sane  mind 
in  the  sound  body;  and  we  to-day  have  come  to 
recognize  fully  how  right  they  were.  It  is  superb 
the  things  that  are  done  nowadays  to  assure  health- 
ful living  in  all  its  aspects  for  our  school  children. 
And  many  of  the  schools  now  building  are  remark- 
able for  salubrity  and  sanitation. 

THE   SCHOOL 

Dr.  L.  L.  La  Fetra  eloquently  maintains  that  the 
school  must  cultivate  first,  health,  strength,  and 
energy.  After  that  should  come  honesty,  cour- 
age, and  patriotism.  And  then  the  ability  to  speak, 
read,  and  write  at  least  the  English  language,  to- 
gether with  a  thorough  assimilation  of  the  essentials 
of  arithmetic.  Upon  this  foundation  all  else  must 
be  built. 

47 


WHY  DIE  SO  YOUNG? 

The  most  important  material  part  of  any  school 
— public,  private,  or  boarding — is  the  schoolroom, 
which  should  be  well  lighted,  the  desks  so  arranged 
that  the  light  comes  preferably  from  the  left  side 
and  the  rear,  so  that  the  shadows  shall  not  fall 
upon  the  writing.  A  north  light  is  more  uniform, 
and  is  therefore  desirable.  The  ventilation  should 
be  ample,  not  only  through  the  windows,  but  also 
by  means  of  inlets  high  up  on  the  walls  and  by 
outlets  low  down  on  the  same  wall. 

There  must  be  a  good  gymnasium,  at  least  a  large 
playground,  in  which  the  nervous  system  is  normal- 
ized and  the  muscles  toned  up.  If  possible,  there 
should  also  be  shower  baths  and  a  swimming  tank. 
The  indoor  temperature  is  62-64  degrees  for  older 
children,  and  from  66  to  70  degrees  for  smaller 
children.  The  best  method  of  heating  is  considered 
to  be  that  by  indirect  radiation. 

An  ideal  location  would  be  on  some  commanding 
knoll,  with  a  grove  to  one  side,  and  sufficient 
grounds  for  games  and  athletics.  Thus  would  the 
aesthetic  instincts  and  the  love  of  the  beautiful  in 
nature  be  fostered.  In  cities  the  schools  are,  when 
possible,  built  facing  a  park.  Their  roofs  may  be 
used  as  playgrounds.  There  should  be  cloak  rooms 
and  individual  lockers,  so  that  parasitic  diseases 
may  not  be  communicated  by  clothing. 

Everything  possible  must  be  done  by  means  of 
games,  sports,  and  manual  training  to  develop 
sound  physiques.  Many  problems  in  moral  and 
intellectual  training  must  be  referred  to  the  play- 
grounds for  their  solution. 

Much  physical  weakness  and  much  deformity 
may  be  relieved  and  corrected  in  the  gymnasium. 

43 


CHILDHOOD 

But  there  must  be  regulation  of  exercise.  The 
amount  of  study  or  muscular  exertion  which  pro- 
duces normal  fatigue  in  a  healthy  child  may  produce 
serious  exhaustion  in  a  child  physically  below  par. 
The  offspring  of  alcoholic  or  neurotic  parents,  the 
anaemic  children,  the  mouth  breathers,  and  those 
who  have  defects  of  sight  and  hearing,  or  who  grow 
rapidly,  and  especially  young  girls  who  are  entering 
the  adolescent  period,  are  very  susceptible  to  col- 
lapse from  overwork.  Such  abnormal  strains  are 
most  apt  to  show  themselves  in  spring,  after  the 
indoor  life  of  the  winter.  Awakening  unrefreshed 
in  the  morning,  inability  to  concentrate  the  atten- 
tion, loss  of  memory,  irritability,  morbid  introspec- 
tion, and  worry  are  early  signs  of  abnormal  fatigue.1 
St.  Vitus's  dance  indicates  a  very  advanced  stage 
of  overfatigue.  The  arrangement  of  studies  should 
be  such  that  those  requiring  more  mental  power, 
as  mathematics  and  grammar,  should  be  taken  up 
in  the  morning,  when  the  mind  is  fresher. 

EXERCISE 

Dr.  J.  Stanley  Hall  strongly  favors  muscle  culture. 
He  finds  physical  training  good  not  for  the  body 
only,  but  also  that  the  very  growth  of  the  brain 
depends  upon  the  right  development  and  use  of  the 
muscular  system;  that  our  mental  and  moral  na- 
tures have  developed  as  our  accessory  muscles  have 
increased  in  number  and  have  grown  in  use;  that 
human  progress,  indeed,  lies  in  increasing  the  ca- 
pabilities of  both  our  fundamental  and  our  acces- 

1  The  days  of  brutally  whipping  children  are  gone;  we  now  instead 
refine  and  whip  their  brains  to  death. — Caille. 

49 


WHY  DIE  SO  YOUNG? 

sory  muscles.  And  his  ideas  are  right.  The  mus- 
cular system  is  best  developed  by  exercise,  and 
when  this  is  judicious  the  child  has  the  best  chance 
of  reaching  normal  adulthood.  Children  get  such 
exercise  naturally  if  they  are  assured  plenty  of 
time  for  play  and  decent  playgrounds.  And  our 
schools  and  municipalities  are  making  full  allow- 
ance for  these  imperative  childhood  needs. 

SENSE   TRAINING 

I  am  myself  a  strong  advocate  of  accurate  sense 
training  in  the  school  child.  Any  philosopher  will 
tell  you  that  our  senses  are  at  best  not  an  infallible 
guide.  And  yet  they  are  the  only  means  by 
which  the  individual  can  gauge  his  internal  relations 
to  the  cosmos  environing  him.  Also  at  their  very 
best  they  can  appreciate  only  phenomena — that  is, 
appearances.  Their  perceptions  must  constantly 
be  corrected  by  innate  reason,  which  must  in 
its  turn  learn  what  it  can  from  experience. 

"Seeing  is  believing;"  but  the  belief  thus 
founded  is  sometimes  proved  to  be  erroneous. 
Seeing,  hearing,  touching,  smelling,  and  tasting, 
reviewed,  and  if  necessary,  having  their  reports 
revised  by  the  reasoning  faculty,  will  then  be 
fairly  veridical.  Only  from  such  process  can  facts 
be  born — facts,  the  sole  building  material  upon 
which  valid  knowledge  can  be  constructed. 

The  stick  appears  broken  in  the  pail  of  water; 
reason,  which  has  learned  something  from  experi- 
ence, assures  us  it  is  not.  Using  a  bright  spoon 
for  a  mirror,  one  appears  variously  grotesque  and 
outre  according  as  he  holds  the  spoon  inside  or 

50 


CHILDHOOD 

outside,  up  or  down  or  sideways;  but  it  is  to  be 
hoped  one's  looking  that  way  is  only  appearance 
and  not  reality.  Cross  the  middle  over  the  index 
finger,  roll  their  tips  over  a  bread  pellet  in  the 
palm  of  the  other  hand,  and  the  sense  of  touch 
will  convey  the  impression  of  two  pellets;  but 
reason,  assisted  by  the  contrary  assurance  of  the 
sense  of  sight,  corrects  the  impression  and  convinces 
us  there  is  but  one.  A  schoolboy  friend  of  mine, 
desiring  to  kodak  me,  placed  me  on  the  porch  of 
a  cottage  on  the  side  of  a  hill,  and  snapped  me 
from  a  dozen  feet  or  so  below.  I  appeared  in  the 
photograph  to  have  elephantiasis  as  to  my  legs, 
a  Taftian  girth,  and  the  head  of  a  Papuan  dwarf. 
All  of  which  is,  I  hope,  not  true  to  nature.  Reason 
must  ever  bring  judgment,  memory,  and  experience 
to  bear  upon  the  perceptions  which  the  senses 
convey  to  the  brain;  by  these  means  reason  must 
constantly  be  rectifying  false  sense.  The  right  sense 
training,  during  elementary  education,  will  relieve 
the  adult  thinking  faculty  of  much  unnecessary 
labor. 

Every  adult  reader  will  recall  occasions  when 
he  has  been  tricked  by  his  senses.  Hundreds  of 
instances  might  here  be  cited  of  delusions,  illusions, 
hallucinations,  experienced  by  the  unscientific,  the 
unsophisticated,  the  highly  emotional;  people  in 
whom  such  aberrations  are  not  without  excuse, 
but  who  might  have  avoided  such  absurdities  had 
their  mental  processes  been  properly  trained  in 
childhood.  And  scientists — that  is,  knowers,  people 
whose  business  is  to  know  (for  science  means 
just  knowing  and  nothing  else),  men  proud  of  their 
powers  of  observation  and  of  their  wonderful  at- 

51 


WHY  DIE  SO  YOUNG? 

tainments,  men  prone  to  consider  delusions,  auto- 
suggestions, and  the  like,  the  exclusive  property  of 
geniuses,  spiritualists,  and  people  whose  imagi- 
nations have  a  way  of  working  overtime,  even 
eminent  scientists — have  been  the  victims  of  psychic 
perturbations.  As,  for  instance,  when  the  tele- 
phone was  invented,  a  lecturer  who  was  giving  a 
public  demonstration  of  the  apparatus  clearly 
and  repeatedly  heard  the  notes  of  a  cornet  which 
he  had  arranged  to  be  played  at  the  other  end  of 
the  wire.  He  declared  that  he  heard;  nor  need 
the  record  be  doubted.  Yet  none  of  his  audience 
could  hear  the  clarion  notes;  and  for  the  all- 
sufficient  reason  that  the  cornetist  had  made  a 
mistake  in  the  date  of  his  appointment  and  was 
not  at  the  place  agreed  upon. 

MEDICAL   SCHOOL   INSPECTIONS 

Medical  school  inspections  are  now  a  matter  of 
course  in  most  American  communities,  as  well  as 
in  the  Philippines  and  in  Hawaii.  Physicians 
engaged  by  health  boards  or  by  departments  of 
education,  or  by  those  agencies  co-operating,  call 
in  the  morning,  examine  such  children  as  are 
found  ailing  by  the  teachers,  and  exclude  from 
the  school  children  having  any  kind  of  infection. 
Thus  is  much  danger  of  disease  to  other  children 
in  the  school,  and  of  epidemics  in  the  community 
averted.  Childhood  infections — mumps,  contagious 
eye  affections,  measles,  scarlet  fever,  and  other 
eruptive  maladies,  whooping  cough,  diphtheria, 
grippe,  infantile  paralysis,  and  the  parasitic  skin 
and  hair  diseases  are  thus  oftentimes  discovered 

52 


CHILDHOOD 

before  it  has  occurred  to  the  parent  at  home  to 
call  in  the  family  doctor. 

More  than  this,  however;  such  physicians  now, 
by  periodic  examination  of  all  the  children  attend- 
ing a  school,  undertake  to  discover  defects  of  all 
kinds,  quite  apart  from  any  consideration  of 
contagiousness.  They  search  especially  for  un- 
toward nutritional  conditions,  heart  and  pulmonary 
disease,  deformities,  defective  hearing,  vision,  and 
teeth,  obstructed  nasal  breathing,  adenoids  and 
diseased  tonsils,  nervous  disorders,  and  defective 
mentality.  A  card  index  is  kept;  and  the  parents 
are  notified  and  are  earnestly  advised  to  have 
their  family  physicians  correct  or  at  least  treat 
the  children  for  the  deficiencies  or  the  diseases 
noted. 

Medical  school  inspections  have  given  some 
really  startling  results.  A  Committee  on  Physical 
Welfare  of  School  Children  found  that  among 
1,400  children  12  per  cent  were  suffering  from 
malnutrition;  48  per  cent  from  bad  teeth;  14 
per  cent  from  eye  defects;  27  per  cent  from  breath- 
ing difficulties;  and  much  other  abnormality. 
And  upon  the  basis  of  such  figures,  these  recom- 
mendations were  made:  There  should  be  periodic 
examinations  of  all  school  children;  notification  to 
all  parents,  followed  when  necessary  by  a  second 
notice  and  visits  to  inform  and  to  persuade  parents 
to  take  proper  action;  the  enforcement  of  existing 
laws  and  a  securing  of  proper  authority,  where 
this  is  now  lacking,  to  compel  parents  who  refuse 
to  do  so  to  take  necessary  steps;  physical  exami- 
nation   of    children    when    they    apply    for    work 

certificates;  enforcement  of  health,  tenement-house, 
5  53 


WHY  DIE  SO  YOUNG? 

and  child-labor  laws.  Departments  of  school 
hygiene  should  be  established  whose  duty  it 
should  be  to  see  that  school  buildings  are  so  con- 
structed and  so  conducted  that  they  cannot  of 
themselves  produce  or  aggravate  physical  defects, 
and  that  the  school  curriculum  should  be  so  devised 
and  executed  as  neither  to  produce  nor  to  aggravate 
physical  and  mental  defects.  The  effect  of  school 
environment  upon  the  child — curriculum,  the  school 
building,  home  study,  physical  training — should 
ever  be  taken  into  account.  And  children  should 
be  taught  hygiene,  so  that  they  will  themselves 
cultivate  habits  of  health  and  see  clearly  the 
relation  of  health  and  vitality  to  present  happiness 
and  future  efficiency. 

Not  only  should  such  medical  inspections  be 
established  in  public  schools — city,  town,  and 
village,  but  also  in  all  others — private,  parochial, 
and  the  like.  It  is  a  truism  that  the  welfare  and 
the  prosperity  of  any  nation  must  depend  upon  the 
health  and  the  stamina  of  its  people;  and  such 
health,  vigor,  and  morale  are  in  turn  conditioned 
upon  the  well-being  of  the  nation's  school  children. 
Nor  can  it  be  doubted  that  the  right  period  and 
place  in  which  to  detect  and,  if  possible,  to  eradicate 
abnormalities  and  degeneracies  in  the  coming 
citizen  are  in  childhood,  and  methodically  in  the 
schools.  Such  examinations  are  logically  within 
the  scope  and  the  province  of  the  governmental 
authorities. 

NUTRITIONAL  DISORDERS 

Many  school  children  are  starved;  they  actually 
have  not  enough  food  to  sustain  their  immature 

54 


CHILDHOOD 

bodies.      Thus    results    anaemia — blood    poverty. 
Many  others  lack  the  food  suitable  for  children. 

Dr.  Harry  Campbell,  a  London  physician,  learn- 
ing that  many  children  of  the  poor  in  that  city 
were  starving,  determined  to  investigate.  And  he 
indeed  found  some  such  cases.  But  in  most  of 
the  families  he  visited  he  found  the  children  suffer- 
ing not  so  much  from  lack  of  food  as  from  too 
much  sweets  and  starches.  Their  appetites  were 
disturbed,  their  digestions  deranged;  consequently 
they  evidenced  much  anaemia  and  their  teeth 
were  as  a  rule  very  bad  indeed. 

Candy  is  good  as  far  as  it  goes,  in  moderation; 
but  it  provides  only  heat  units  and  is  not  a  tissue 
builder.  Candy  develops  energy;  it  is  mostly 
carbon,  and  if  we  were  to  eat  candy  alone  we  would 
be  like  a  fire  that  must  sooner  or  later  burn  itself 
up  into  nothingness.  In  moderation,  as  dessert  after 
a  good  meal,  candies  are  in  their  proper  place. 

Cakes  and  other  sweet  foods  are  usually  com- 
pounded of  flour  and  eggs,  butter  or  other  fat — 
and  plenty  of  sugar.  They  are  more  nutritious 
than  candy  alone,  and  many  can  consume  them 
without  digestive  disturbance.  But  in  other  cases 
there  are  much  heartburn  and  other  evidences  of 
indigestion,  by  reason  mostly  of  sugar  excess. 
Especially  should  children  thus  affected  eat  little 
of  sugar,  jam,  marmalade,  sirups,  sweet  cakes, 
and  other  food  sweetened  with  sugar.  Less  likely 
to  cause  dyspepsia  are  honey,  molasses,  and  maple 
sirup. 

In  many  public  schools  the  children  must  either 
take  from  home  a  cold  lunch,  or  they  must  go 
home,  gulp  down  a  warm  meal  in  the  good  old 

55 


WHY  DIE  SO  YOUNG? 

American  fashion,  and  then  run  back  to  their  les- 
sons. This  is  baneful  during  the  period  of  active 
growth,  when  there  should  be  plenty  of  wholesome 
food  eaten,  with  a  decent  regard  for  the  capabilities 
and  the  limitations  of  the  digestive  tract. 

In  many  schools  the  civic  authorities  have  pro- 
vided hot  lunches  for  the  children.  In  some 
schools  the  children  pay  the  cost  price  for  those 
lunches.  In  others  they  either  pay  or,  if  they 
have  not  brought  the  money  with  them,  the  food 
is  given  them  free.  I  personally  am  adverse  to 
the  latter  practice;  but  that's  another  story. 

THE  APPENDIX 

In  a  few  cases  the  appendix  is  responsible  for 
nutritional  disturbances.  I  am  not  precisely 
urging  that  every  infant  should  have  its  appendix 
removed,  along  with  having  drops  instilled  at  its 
birth  within  its  lids,  so  that  it  will  not  develop 
sore  eyes,  and  being  vaccinated  against  smallpox, 
and  being  inoculated  against  possible  typhoid 
fever,  and  getting  a  preventive  dose  of  anti- 
meningitis  serum,  also  one  against  whooping 
cough,  and  having  a  prophylactic  dose  of  diphtheria 
antitoxin,  and  undergoing  a  lumbar  puncture 
against  the  contingency  of  infantile  paralysis,  and 
having  its  tonsils  clipped  off  and  its  adenoids 
scooped  out,  and  so  on  and  so  on.  I  should, 
however,  just  like  to  observe  that  infants  have 
had  appendicitis  before  they  have  been  born. 
Nor  is  the  disease  so  very  infrequent  in  children 
under  two  years. 

That  pre-eminent  surgeon,  Dr.  William  T.  Bull, 

56 


CHILDHOOD 

took  no  chances.  He  removed  the  appendix  of  his 
six-days-old  baby.  There  was  nothing  in  particular 
the  matter  with  it — not  as  yet.  He  simply  did  not 
care  to  have  that  useless  rudiment  remain  where 
it  might  possibly  make  trouble  later  in  life. 

HEAET   DISEASE   IN   CHILDREN 

Robert  Louis  Stevenson's  "Pity  Sick  Children" 
springs  at  once  to  mind  when  one  comes  upon  a 
blue-lipped,  dropsy-faced,  panting  child,  its  blue 
jugulars  pulsating  prominently  against  its  white 
neck  and  its  heart  beating  tumultuously  against 
its  ribs,  like  a  frightened  little  bird  quivering 
against  its  cage.  It  is  most  gratifying  to  realize 
that  such  suffering,  when  it  is  not  of  congenital 
origin,  is  now  in  large  part  preventable,  because  it 
has  been  found  in  most  cases  to  be  of  germ  origin. 
Rheumatic  heart  disease  is  the  most  serious  and 
the  most  frequent  of  the  organic  heart  affections, 
in  children  as  in  adults;  and  the  germ  of  rheu- 
matism, the  streptococcus  rheumaticus,  the  essen- 
tial cause  of  that  disease  has  been  discovered. 

RHEUMATISM   IN   CHILDREN 

During  the  first  four  years  of  life,  rheumatism  is 
fortunately  rare;  probably  because  infants  and 
little  children  are  not  so  much  exposed.  After 
four  years,  however,  when  children  get  about, 
often  in  unseasonable  weather,  come  in  contact 
with  other  children  in  perhaps  crowded  and  un- 
hygienic schools,  are  in  the  streets  inhaling  germ- 
laden  dust — then  it  is  that  the  rheumatism  incidence 

57 


WHY  DIE  SO  YOUNG? 

rises  steadily  to  the  tenth  year.  The  child's  body 
also  becomes  susceptible  to  the  infection  by 
reason  of  ansemia,  especially  in  rapidly  growing 
children;  imperfect  convalescence  after  other  dis- 
seases;  overstrain  at  play.  Thus  are  the  bodily 
tissues  rendered  congenial  soil  for  the  rheumatism 
germ  to  implant  itself  and  to  thrive  and  multiply 
in.  Favorite  spots  for  such  weedy  growth  are 
unhealthy  tonsils  and  upper  air  passages;  neglected 
teeth  and  gums,  very  frequently;  inflamed  or 
running  middle  ears.  Other  predisposing  agencies 
are  cold  and  damp  and  the  insanitation  obtaining 
in  stuffy  and  crowded  quarters.  From  such  in- 
fection centers  the  germ  finds  its  way  through  the 
lymph  and  blood  channels,  not  only  to  the  joints, 
but  to  the  heart  valves,  the  muscular  tissue,  and  the 
interior  of  that  most  vital  organ;  to  the  pericardium, 
also,  in  which  the  heart  lies.  And  the  baneful  infec- 
tion comes  about  by  reason  not  only  of  the  presence 
of  the  germs  themselves,  but  also  of  the  poisons,  the 
toxins,  which  those  rheumatism  streptococci  gener- 
ate in  the  vulnerable  tissues. 

The  prevention  of  rheumatism,  or  of  the  re- 
currence of  the  disease,  in  children,  requires  our 
taking  into  account  the  untoward  influence  of 
crowded  towns,  damp  houses,  poor  sanitation, 
unhealthful  soils  and  climates.  The  child's  dwelling 
should  be  thoroughly  dry  indoors;  cold,  damp, 
crowded,  and  stuffy  rooms  are  especially  to  be 
avoided,  predisposing,  as  they  do,  to  chills  and 
sore  throats.  Damp  clothes  and  damp  beds 
have  proved  even  fatal  to  a  rheumatic  child. 
The  soil  about  the  house  should  be  gravel  rather 
than  clay.     A  warm  and  equable  atmosphere,  as 

58 


CHILDHOOD 

devoid  as  possible  of  bleak  winds,  sultry  heats, 
and  germ-laden  dust,  would  be  ideal.  Occasional 
change  of  air  and  scene  is  good  for  such  children. 

Rheumatic  children  are  likely  to  be  more  than 
usually  bright,  emotional,  and  energetic;  they  tire 
their  bodies  before  they  tire  their  minds;  where- 
fore discipline,  rest  after  the  midday  meal,  and 
early  bedtime  hours  must  be  enforced,  especially 
when  such  children  are  nervous  and  emaciated. 

The  digestive  organs  need  careful  supervision, 
for  they  are  often  disordered,  night  terrors,  hives, 
and  migrainous  sick  headaches  resulting.  Such 
children  should  be  constantly  under  the  family 
doctor's  supervision. 

The  gums  and  teeth  must  be  most  carefully 
looked  after.  The  throat  will  need  especial  care; 
for,  as  we  have  seen,  a  very  usual  path  of  invasion 
of  the  rheumatism  germ  is  by  way  of  the  tonsils. 
Children  should  be  taught  as  early  as  possible 
to  gargle;  half  a  teaspoonful  of  table  salt  to  a 
tumblerful  of  hot  water  makes  a  good  solution. 
The  diet  should  be  plain  and  varied — meat  once  a 
day  for  a  child  of  seven.  Warm  clothing  is  very 
necessary;  woolen  undergarments  for  winter;  the 
best  possible  quality  of  interwoven  wool  and  silk 
for  summer;  good  boots  and  warm  socks. 

Children  prone  to  rheumatism  should  not  be 
forced  to  much  study,  which  tends  to  lower  the 
child's  resistance.  If  we  can  tide  the  rheumatic 
child  over  his  youth  he  will  become  later  in  life 
less  susceptible  to  cardiac  rheumatism. 

The  logic  of  the  situation  requires  first  the 
safeguarding  of  the  child  against  the  rheumatic 
infection,  precisely  as  against  the  scarlet  fever  or 

59 


WHY  DIE  SO  YOUNG? 

the  measles  or  any  other  infection;  and  secondly, 
the  child's  constitution  must  be  hardened,  must  be 
fortified  against  any  such  infection  by  hygienic 
measures,  by  maintaining  the  child  in  a  sanitary 
environment,  and  by  having  such  reachable  in- 
fection centers  as  we  have  indicated  cleared  up. 
These  observations  may  apply  equally  well  to 
diphtheria,  pneumonia,  tuberculosis,  grippe,  ty- 
phoid— in  fact,  to  any  of  the  infections  to  which 
infancy  and  childhood  are  prone. 

TUBERCULOSIS   IN   CHILDHOOD 

We  have  dwelt  on  tuberculosis  in  infants.  During 
the  first  four  years  of  life  this  disease  claims  many 
victims;  from  then  on,  however,  and  up  to  ado- 
lescence, the  list  of  those  slain  by  the  Captain  of 
the  Men  of  Death — as  John  Bunyan  characterized 
consumption — is  lessened.  But  with  the  fifteenth 
year  and  up  to  the  forty -fifth,  every  fourth  or 
more  among  our  white  race,  and  every  other  adult 
among  our  negroes,  succumbs  to  the  Great  White 
Plague.  Yet  in  childhood,  from  the  fifth  year  on, 
exposure  to  the  tuberculous  infection  is  manifestly 
no  less  than  in  other  eras;  indeed,  it  is  generally 
greater  than  during  later  life.  There  is,  then,  a 
latency  during  those  earlier  years,  remaining  until 
tuberculous  centers  in  the  body  become  irritated 
and  weak  spots  become  manifest,  by  reason  of  the 
unusual  stresses  and  perturbations  which  the 
youthful  organism  has  to  undergo. 

There  is,  therefore,  the  extremest  necessity  to 
examine  children  in  their  school-going  period  for 
the  detection  and  removal,  as  far  as  possible,  of 

60 


CHILDHOOD 

all  causes  and  agencies  which  may  lead  to  con- 
sumption. We  must  try  ever  to  understand  why 
a  child  of  generally  agreeable  disposition  becomes 
fretful,  irritable,  nervous,  easily  fatigued,  unable 
to  concentrate  the  attention;  why  it  is  pale, 
feverish  and  chilly  by  turns;  why  it  has  headache, 
nausea,  or  loss  of  appetite,  difficulty  in  swallowing; 
whether  it  has  a  persistent  dry  cough;  pain  in 
the  back,  especially  when  the  spinal  bones  are 
pressed  on;  girdle  sensations;  difficulty  with  its 
kidneys  or  its  digestion.  We  must  learn  why 
such  a  child  is  below  the  average  weight,  or  if  it 
has  suffered  some  very  weakening  constitutional 
disease;  if  there  are  nasal  or  throat  obstructions 
leading  to  mouth  breathing;  ear  trouble  or  muscular 
spasms;  tender  or  swollen  joints  or  a  painful  or 
distended  abdomen.  By  such  careful  consideration 
of  symptoms  and  by  scientific  preventive  measures 
we  may  eliminate  a  vast  deal  of  suffering,  a  vast 
deal  of  tuberculosis,  the  most  melancholy  of  all 
diseases. 

DEFORMITIES 

Spinal  curvature  may  be  due  to  real  disease 
(mostly  tuberculosis)  of  the  vertebra?,  or  weak 
back  muscles  may  be  at  fault.  Bad  posturing  is 
responsible  for  most  of  the  lesser  grades  of  spinal 
curvature,  as  also  of  other  structural  abnormalities. 
The  teaching  of  proper  standing,  walking,  and 
sitting  is  now  a  part  of  all  school  discipline,  and  a 
most  grateful  one.  Especially  to  be  appreciated 
in  this  regard  are  the  military  schools. 
-  Lateral  curvature — scoliosis — may  result  from 
malposition  of  the  pelvis,  one-sided  position  of  the 

61 


WHY  DIE  SO  YOUNG? 

body,  or  the  contraction  of  one  side  of  the  body, 
following  a  bad  attack  of  pleurisy.  Or  there  is  a 
contraction  of  the  spinal  muscles  of  one  side, 
following  paralysis  of  the  opposing  muscles.  All 
spinal  deformities  are  greatly  influenced  by  hered- 
ity, general  weakness,  a  sickly  or  scrofulous  bodily 
condition.  Children  who  grow  very  rapidly,  assum- 
ing the  while  faulty  positions  at  their  school  desks, 
may  become  "scoliotic." 

Those  who  have  lateral  curvature  either  develop- 
ing or  obvious  are  prone  to  pain,  a  feeling  of 
weakness  in  the  back,  general  lassitude,  a  stooping 
gait,  a  prominence  of  the  shoulder  blade,  and 
perhaps  also  of  the  hip,  on  the  affected  side.  The 
affection  can  be  cured  if  too  great  deformity  has 
not  developed.  Muscular  exercises  are  in  most 
cases  beneficial;  or  a  suitable  support  may  be  worn. 
As  to  these  matters  a  family  doctor  must  decide. 

Kyphosis  is  an  undue  bulging  backward  of  the 
spine.  This  results  from  muscular  weakness, 
rickets,  slouchy  habits,  or  too  much  stooping. 
Children  having  this  deformity  (hunchback)  very 
marked,  may  have  been  let  to  fall  in  infancy.  In 
others  there  has  been  Potts's  disease  (tuberculosis) 
of  the  spine.  Lordosis  is  an  undue  curving  forward 
of  the  spine — the  very  hollow  back. 

Hip  disease  (tuberculosis  of  that  joint)  and 
other  joint  abnormalities  should  be  brought  as 
early  as  possible  to  the  attention  of  the  orthopaedic 
surgeon. 

INFANTILE   PARALYSIS 

Among  joint  deformities,  surely  none  are  more 
melancholy  than  those  which  are  a  part  of  the 

62 


CHILDHOOD 

disease  infantile  paralysis.  This  is  called  by 
physicians,  acute  anterior  poliomylitis,  because 
this  infectious  inflammation  invades  mostly  the 
anterior  nerve  roots,  the  telegraph  stations,  as  it 
were,  in  the  gray  marrow  or  matter  (polio,  myel) 
of  the  spinal  cord.  It  is  from  these  roots  or  ganglia 
that  muscular  movements,  especially  those  of  the 
extremities,  are  normally  directed,  controlled,  and 
co-ordinated. 

During  several  years  past,  devoted  and  zealous 
physicians  have  been  laying  the  chain  in  which 
the  germ  origin  of  infantile  paralysis  has  become 
established.  Dr.  Simon  Flexner,  and  his  associates 
of  the  Rockefeller  Institute  in  New  York,  have 
demonstrated  that  a  specific,  an  essential  virus,  is, 
in  the  last  analysis,  responsible  for  this  disease. 
Blows,  accidents,  falls,  previous  weakening  ailments, 
are  but  predisposing,  making  the  body  susceptible, 
vulnerable  to  the  inroads  of  the  virus.  The  latter 
is  "a  minute,  filterable  micro-organism  which  has 
now  been  secured  in  artificial  culture,"  and  as 
such  is  distinctly  visible  under  the  higher  powers 
of  the  microscope.  It  enters  the  body  by  way  of  the 
nose  and  throat,  whence  it  traverses,  in  the  blood 
and  lymph  channels,  the  honeycomb — like  bony 
tissue  at  and  about  the  base  of  the  brain,  thence 
to  invade  the  anterior  nerve  roots.  Sometimes 
also  the  inflammation  ascends  from  the  anterior 
nerve  roots  to  the  neck  and  the  brain,  producing 
respiratory  paralysis  and  death.  Happily,  however, 
in  most  cases,  the  brain  and  the  mind  are  un- 
affected, though  the  bodily  deformities  may  be 
dreadful  in  extent. 

As  with  diphtheria  and  other  infections,  there  may 

63 


WHY  DIE  SO  YOUNG? 

be  carriers  of  the  infantile  paralysis  virus  or  germ — 
people  who  may  not  themselves  come  down  with 
the  disease.  The  virus  is  communicated  from  the 
sick  to  the  well,  either  directly  or  through  a  third 
person,  by  contact  with  the  nasal,  throat,  or  buccal 
discharges  of  the  afflicted  on  handkerchiefs,  towels, 
eating  utensils,  toys,  and  the  like,  or  by  kissing, 
coughing,  or  sneezing. 

And  so  an  infant  of  perhaps  no  more  than  nine 
months  may  be  put  to  bed  seemingly  well,  to 
awaken  in  the  morning  with  a  high  fever,  vomiting, 
and  convulsions.  Or,  if  the  child  be  old  enough 
to  tell  of  its  sufferings,  it  will  complain  of  headache, 
of  pain  and  tenderness  in  the  neck  and  back  along 
the  spine.  It  will  be  restless,  irritable,  and  sleep- 
less; or  it  will  be  drowsy  and  stupid.  In  from 
twelve  hours  to  two  or  four  days  will  ensue  flaccid 
paralysis  of  one  or  more  members,  and  in  time 
wasting  away  of  the  affected  muscles.  Children  of 
from  one  to  five  years  are  most  frequently  attacked, 
but  adults  also  may  suffer.  The  summer  months 
are  the  favorable  season  for  this  disease,  but  cold 
is  no  bar  to  it.  There  have  been  epidemics  in  the 
arctics.  No  antitoxic  serum,  either  preventive  or 
curative,  is  as  yet  assured,  nor  is  any  positive  cure, 
medicinal  or  otherwise,  as  yet  perfected. 

The  incubation,  the  hatching  period,  during 
which  the  toxin  of  the  infection  is  developing  in 
the  system,  is  from  three  to  twenty-one  days. 

Much  good  is  accomplished  for  the  sufferer  by 
rest  in  bed,  diet,  medicines  addressed  to  the  fever, 
the  pain,  and  other  symptoms,  with  electricity 
and  massage,  after  the  acute  manifestations 
have  subsided,  and  other  means  familiar  to  the 

64 


CHILDHOOD 

physician.  Much  may  be  accomplished  to  prevent 
the  crippling  and  deforming  of  children  who  do 
not  die.  Even  so,  more  than  half  the  survivors  are 
likely  to  suffer  afterward  from  paralysis;  and  in 
the  recovered  ones  the  affected  muscles  are  likely 
to  remain  small,  with  retarded  bone  development, 
poor  circulation,  and  impaired  constitutions. 

Obviously,  then,  since  there  is  no  certain  cure, 
our  efforts  are  most  wisely  directed  to  preventive 
measures.  The  sick  of  infantile  paralysis  must  be 
quarantined  for  a  period  of  six  weeks. 

The  disease  must  be  managed  as  any  infectious 
disease,  and  according  to  the  directions  of  one's 
physician  and  health  department.  Especially 
must  healthy  children  be  debarred,  during  the 
period  of  any  epidemic,  from  parties,  picnics, 
movie  shows,  outings,  and  the  like;  nor  may  they 
play  with  children  in  whose  homes  there  is  sickness. 
Here,  as  in  disease  prevention  generally,  the  basic 
factor  is  personal  hygiene. 

IMMUNITY 

"What  is  immunity?  The  knowledge  is  at  least 
as  old  as  the  history  of  medicine  that  a  single 
attack  of  an  infectious  disease  makes  the  survivor, 
at  least  probably,  and  in  most  cases  absolutely, 
immune  to  further  attacks  of  that  particular  disease. 
That  is  why  so  many  infections — diphtheria, measles, 
scarlet  fever,  whooping  cough — are  childhood  dis- 
eases, suffered  during  that  period  once  and  for 
all,  in  life.  This  so  ancient  knowledge  has  been 
at  the  bottom  of  the  search  for  immunizing  agents, 
which  humankind  has  ever  been  making.    To-day 

65 


WHY  DIE  SO  YOUNG? 

we  use  antivenins,  substances  extracted  from 
snake  bodies,  quite  as  Galen  (the  doctor  of  that 
Nero  who  fiddled  when  Rome  burned)  gave  his 
patients  viper  flesh  and  viper  blood  for  the  same 
purpose.  We  read  that  the  Persian  king,  Mithri- 
dates,  immunized  himself  against  poison  by  taking 
all  the  antidotes  known  in  his  time,  experimenting 
on  condemned  prisoners  until  he  found  the  doses 
he  could  safely  take.  He  did  this  because  ambitious 
members  of  the  royal  family,  wanting  the  king's 
throne,  were  likely  to  resort  to  poisoning  to  that 
end.  Those  bitten  by  rabid  dogs  were  advised  by 
mediaeval  doctors  to  eat  the  liver  and  drink  the 
blood  of  the  guilty  canines;  and  the  Pasteur 
treatment  for  hydrophobia  is  but  a  modern  and 
more  elegant  refinement  based  on  the  same  princi- 
ple. The  idea  is  the  same  as  "eating  a  hair  of 
the  dog  that  bit  you";  and  this  is  the  basis  of  the 
only  but  real  hydrophobia  cure  there  is  to-day. 

Doctor  Jenner  observed,  about  the  time  of  our 
American  Revolution,  how  dairy  folk  that  got  the 
matter  of  the  udder  sores  of  cows  (cowpox)  into 
cuts  in  their  hands  were  immune  to  smallpox;  by 
his  inoculations,  then,  of  such  cow  virus  (vaccine) 
he  assured  protection  against  the  much  more 
dreadful  and  fatal  smallpox. 

Thus  began  vaccination  in  the  modern  sense,  for 
Pasteur  developed  into  a  scientific  working  principle 
Jenner 's  demonstration  of  a  mild  form,  protecting 
against  a  severe  form,  of  a  given  infection.  In 
precise  terms  immunity  is  an  individual's  resistance 
to  an  infectious  disease  to  which  the  race  in  general 
is  susceptible.  Such  immunity  depends  on  the 
defensive  reaction   of   the  body's   resisting   force 


CHILDHOOD 

to  the  poison — toxin — either  of  the  disease  itself 
or  to  such  minute  portions  of  that  poison  as  are 
contained  in  the  immunizing  agent.  There  may 
be  acquired,  or  natural,  or  active,  or  passive 
immunity.  Immunity  is  acquired  on  recovery 
from  an  attack  of  a  given  infection — as  of  scarlet 
fever.  Negroes  are  practically  safe  from  yellow 
fever;  theirs  is  a  natural  immunity,  resulting 
from  their  having,  through  countless  generations 
in  their  native  Africa,  been  "up  against  yellow 
jack."  Call  this  racial  immunity  if  you  like. 
Our  very  good  friend  the  horse  is  actively  im- 
munized against  diphtheria  when  we  inject  into 
him  the  poison  of  that  disease;  then  we  take  the 
serum  from  his  blood  and  use  it  to  confer  passive 
immunity  on  those  of  our  kind  who  are  in  danger 
of  diphtheria.  Besides  the  diseases  mentioned  we 
have  antitoxins  (immunizing  agents)  against  te- 
tanus (lockjaw),  meningitis,  typhoid  fever,  typhus 
fever,  cholera,  and  other  infections. 

DEFECTIVE  HEARING 

Many  a  dunce,  many  a  vicious  child,  in  the  old 
days  of  the  little  red  schoolhouse,  has  been  just 
a  child  whose  hearing  has  not  been  up  to  par. 
A  simple  test  is  to  have  the  child  put  his  hand  over 
one  ear  and  then  to  whisper  to  it  a  few  words  at 
ten  feet  distance.  If  the  child  cannot  repeat  your 
words  there  is  some  difficulty  with  his  aural  appa- 
ratus. Having  thus  tested  one  ear,  try  the  other 
in  the  same  way.  If  there  is  no  hearing  at  ten 
feet  you  approach  the  child  foot  by  foot  and 
repeat  the  whisper  each  time.    If  he  hears  you  at 

67 


WHY  DIE  SO  YOUNG? 

only  three  feet,  then  his  hearing  is  only  three- 
tenths  normal. 

Or  there  is  the  watch  test:  The  average-sized 
watch  should  be  heard  by  the  normal  ear  of  a 
young  person  at  forty  to  fifty  inches.  At  thirty 
inches  the  hearing  is  fair.  (As  age  advances  the 
watch-hearing  distance  gradually  diminishes;  after 
sixty  years  it  may  be  completely  lost  in  those  who 
may,  nevertheless,  hear  sufficiently  for  the  ordinary 
purposes  of  life.) 

Possibly  the  child's  difficulty  is  by  reason  of 
wax,  or  some  foreign  body,  which,  being  removed 
from  the  external  canal,  the  hearing  is  restored. 
In  most  cases,  however,  the  difficulty  lies  in  in- 
flammation of  some  sort. 

AURAL  DISEASE 

An  aural  catarrh  is  the  first  stage  of  practically 
all  the  diseases  of  the  ear  and  of  their  complications, 
and  such  acute  middle-ear  inflammation  is  in 
turn  very  often  caused  by  infection  extending 
through  the  Eustachian  tube,  which  latter  tunnels 
the  region  between  the  throat  and  the  middle  ear. 
Thus  the  ear  trouble  starts  as  a  local  manifestation 
of  such  diseases  as  coryza,  diphtheria,  measles, 
bronchitis,  scarlet  fever,  whooping  cough,  mumps, 
grippe,  pneumonia — all  infections  ushered  in  by 
inflamed  noses  and  throats.  Whenever  these 
diseases  have  not  been  prevented,  symptoms  refer- 
able to  the  ear  must  be  constantly  watched  for, 
so  that  the  hearing  sense  may  not  be  imperiled. 
There  may  appear  simply  a  dry  catarrh,  ac- 
companied by  an  obstructed  sensation,  not  always 

6S 


CHILDHOOD 

painful,  in  one  or  both  ears;  upon  which  suppura- 
tion (abscess)  all  too  often  supervenes.  And  then, 
all  too  often  again,  either  directly  through  the 
tissues  or  by  way  of  the  blood  and  lymph  vessels, 
will  be  involved  the  mastoid  process,  that  bony 
projection  felt  immediately  behind  the  ear.  This 
process  is  made  up  of  spongy  bone  tissue,  through 
which  inflammation  easily  travels  and  which  soon 
becomes  pus  soaked.  Nor  in  many  cases  will  the 
trouble  rest  here;  it  will  become  by  extension  an 
infectious  meningitis,  or  a  brain  abscess,  or  a 
plugging  up  of  the  great  veins  within  the  skull, 
with  corrupted  brain  tissue  as  a  result,  and  all  too 
often  death.  Or  the  middle-ear  suppuration  may 
become  chronic — that  is,  a  child  may  for  months 
have  "running  ears,"  which  become  a  focus  of 
infection,  the  pus  of  which  is  like  so  much  dynamite, 
ready  to  explode  at  any  time  when  some  super- 
vening bodily  predisposition  becomes  the  igniting 
spark. 

The  baneful  effects  of  "matter"  found  in  the 
middle  ear  will  vary  according  to  the  nature  of  its 
miscroscopic  elements.  Sometimes  the  most  viru- 
lent ear  discharges  have  no  odor;  the  deadliest 
may  have  a  sweetish  odor,  like  that  of  new-mown 
hay;  or  it  may  have  considerable  fetor  like  that 
of  a  decayed  egg.  Here  the  bony  tissue  is  certainly 
breaking  down.  No  such  cases  must  be  neglected. 
By  a  laboratory  examination  under  the  microscope 
(so  easy  of  accomplishment  in  our  day  when, 
besides  private  laboratories,  public,  state,  county, 
and  municipal  facilities  are,  if  need  be,  at  the 
family  physician's  disposal),  we  can  detect  in  each 
case  the  respective  disease  germ  that  has  to  be 
6  69 


WHY  DIE  SO  YOUNG? 

feared,  be  it  the  grippe,  or  the  typhoid,  or  the 
meningitis,  or  the  rheumatism  germ,  or  the  pus 
germ.  And  how  many  a  case  of  tuberculosis  in 
childhood  has  developed  from  the  germs  of  that 
disease  found  in  the  aural  discharges ! 

EYE   DEFECTS 

If  a  child  is  to  learn,  it  must,  of  course,  have 
good  eyesight.  Except  hearing  difficulty,  little 
can  be  more  distressing  to  the  school  child  than 
errors  of  refraction — especially  myopia,  near- 
sightedness. How  many  a  child  accounted  stupid 
and  perverse  has  become  amiable  and  a  bright 
scholar  on  the  fitting  to  the  eyes  of  the  right 
glasses. 

For  children  who  squint  to  be  taunted  by  their 
companions  as  being  "goggle  eyed"  constitutes 
one  of  child  life's  near  tragedies.  Such  children 
should  receive  the  eye  specialist's  most  skillful 
attention.  Indeed,  it  is  a  very  wise  rule  to  have 
every  child's  eyes  examined  before  its  entrance 
on  school  life.  Squint  in  children  that  is  caused 
by  paralysis  of  one  or  more  of  the  six  eye  muscles 
should  be  rectified  (the  earlier  the  better) ,  either  by 
suitable  prism  glasses  or  by  operation  (by  which 
the  muscles  at  fault  are  either  shortened  or  ad- 
vanced). The  squint  (which  doctors  call  stra- 
bismus) being  rectified,  we  have  to  consider  next 
the  poor  vision,  which  may  be  due  either  to  far 
or  to  nearsightedness;  and  then  along  with  one 
or  the  other  of  these  errors  of  refraction  there  may 
be  astigmatism  (deviation  from  the  normal  curve 
of  the  cornea,  the  circular  part  immediately  in 

70 


CHILDHOOD 

front  of  the  pupil).  I  am  assuming  that  there 
are  no  white  spots  on  the  cornea,  which  are  due 
to  diphtheria  or  scarlet  fever  or  measles  or  any 
grievous  childhood  inflammation.  Many  a  very 
young  child  squints  when  it  is  ill.  Physical  weak- 
ness may  temporarily  cause  this;  and  there  are 
children  that  grow  up  with  a  squint  and  lose  it  in 
their  teens,  to  have  it  reappear  only  when  they  are 
tired,  in  the  evening,  and  when  they  have  over- 
worked at  their  studies.  Here  may  be  a  warning 
of  the  existence  of  a  weak  brain  control,  and  a 
hint  to  be  watchful  against  the  effects  of  over- 
study.  Medicines  are  of  no  use;  electricity  should 
not  be  used  except  by  expert  direction;  gentle 
massage  over  the  closed  lids  is  a  splendid  tonic 
for  weak  eye  muscles. 

THE   TEETH 

A  great  deal  of  suffering,  a  great  deal  of  real 
disease,  and  of  systematic  infection  can  be  avoided 
by  the  habit  of  attending  to  the  hygiene  of  the 
teeth.  I  do  not  know  of  any  subject  in  personal 
hygiene  to  which  I  would  attach  more  importance. 

Digestion  does  not  begin  in  the  stomach;  it 
begins  in  the  mouth.  If  this  truth  were  realized 
a  great  many — though  far  from  all — cases  of 
dyspepsia  would  "fold  their  tents,  like  the  Arab, 
and  as  silently  steal  away,"  never  more  to  affect 
the  sufferer.  The  first  thing  necessary  to  good 
digestion  is  to  have  the  food  thoroughly  chewed, 
so  that  it  is  in  a  condition  to  be  readily  mixed  with 
the  digestive  juices,  the  first  of  which  is  the  saliva 
in  the  mouth.  How  necessary,  then,  is  it  to  keep 
the  mouth,  the  teeth,  and  the  gums  in  good  condi- 

71 


WHY  DIE  SO  YOUNG? 

tion!  How  salutary  to  this  end  is  the  advice  to  go 
to  the  dentist  at  least  once  a  year,  and  have  those 
precious  masticators  overhauled  and  kept  right! 

The  teeth  should  be  brushed  at  least  on  rising 
and  at  bedtime;  and  the  mouth  should  be  rinsed 
with  water  after  each  meal.  Any  one  of  the  many 
dentifrices  now  in  the  market  is  right.  Also  clean 
the  spaces  between  the  teeth  with  dental  floss. 
Soft  wooden  toothpicks  are  well  enough,  but 
picks  made  of  hard  substances  are  apt  to  injure 
the  precious  enamel.  You  would  be  surprised  to 
hear  how  much  tooth  irregularity  in  children  is  due 
to  the  mouth-breathing  habit;  see,  therefore,  that 
any  possible  adenoids  or  enlarged  tonsils  in  your 
child's  throat  are  attended  to.  Have  your  children 
get  the  teeth -preserving  habit  in  early  childhood. 

By  beginning  with  childhood  the  hygiene  cf  the 
mouth  we  shall  avoid  the  danger  of  incurring 
Riggs's  disease.  This  most  chronic  ailment,  Pyor- 
rhoea alveolaris,  is  a  process  destructive  of  the 
supporting  structures  of  the  human  tooth.  What 
are  the  causes?  The  proper  hygiene  of  the  teeth 
and  mouth  has  been  neglected;  or,  in  the  dentist's 
phrase,  there  has  been  "absence  of  the  normal 
contacts"  between  the  upper  and  lower  teeth; 
or  the  teeth  have  grown  very  irregularly.  Mercu- 
rial, lead,  arsenic,  phosphorous,  and  other  metallic 
poisoning  in  dangerous  trades  is  often  a  cause; 
also  rickets  in  children  and  diabetes  in  adults. 
Worst  of  all,  various  disease  germs  deposited  in 
tooth  cavities  or  in  decayed  roots  pass  thence 
through  the  lymph  and  blood  channels  to  other 
parts  of  the  body,  such  as  the  joints,  setting  up 
rheumatism    and    other   serious   diseases.      When 

72 


CHILDHOOD 

there  is  lodgment  of  decaying  food  in  the  spaces 
between  the  teeth,  the  mouth  becomes  unclean, 
there  is  bad  breath  and  bad  taste,  autotoxemia 
(self-poisoning)  by  such  impurities,  and  conse- 
quently general  ill  health.  In  Riggs's  disease 
there  is  a  dull  gnawing  pain  in  and  about  the 
teeth,  the  gums,  and  the  tooth  sockets.  While 
chewing  food  the  mouth  feels  tender  and  sore. 
There-  is  dark  red  discoloration  of  the  gums  and 
bleeding  of  the  spongy  ulcerated  gums  on  the 
slightest  irritation.  In  advanced  cases  pus  can 
be  forced  around  the  necks  of  the  teeth  involved, 
from  practically  all  the  pockets  found.  X-rays 
are  now  taken  of  the  jaws  which  in  many  cases 
show  startling  abscess  formations  not  only  in  the 
teeth,  but  also  in  the  jaws  around  the  teeth.  The 
hygiene  of  the  teeth  begun  early  in  childhood  will 
prevent  most  cases  of  Riggs's  disease. 

SNUFFLES 

"Cold  in  the  head"  prevails  more  in  children 
than  in  older  folk.  It  comes  on  of  itself;  or  it 
accompanies  many  diseases  such  as  measles,  scarlet 
fever,  diphtheria,  mumps,  and  the  like;  and  then 
the  nasal  discharges  are  very  "catching."  Such 
secretions  of  the  little  sufferer,  when  put  under 
the  microscope,  will  show  various  germs,  those  of 
grippe  or  bronchitis  or  even  pneumonia.  The 
child  catches  its  acute  nasal  catarrh  in  two  ways — 
because  of  the  lowering  of  the  natural  resistance 
through  exposure  to  cold  or  damp,  or  by  reason  of 
unnutrition;  or  the  catarrh  may  have  passed 
by  personal  contact  of  the  infectious  material 
so  that  it  becomes  a  "household  cold." 

73 


WHY  DIE  SO  YOUNG? 

The  child  may  at  the  outset  suffer  with  chilliness 
and  headache,  and  give  evidence  of  being  out  of 
sorts.  Then  the  nose  "runs,"  a  watery  secretion 
appearing;  with  this  the  nose  gets  clogged  up  and 
the  child  snuffles,  breathes  with  difficulty,  and  has 
to  keep  its  mouth  open  to  breathe  at  all.  The 
obstruction  is  worse  when  the  child  is  lying  down 
on  its  back,  causing  much  discomfort  at  night; 
in  infants,  indeed,  attacks  of  suffocation  may  result 
and  breast  feeding  be  interfered  with.  After  a 
time  the  watery  secretion  increases  and  at  the 
end  of  a  day  or  two  becomes  considerable  in 
quantity,  the  swelling  of  the  mucous  membranes 
of  the  nose  at  the  same  time  lessening,  so  that 
the  nose  breathing  becomes  easier.  The  discharge, 
while  it  becomes  less  in  quantity,  becomes  also 
thicker,  and  finally  dries  up*  altogether  after  a 
week  or  two.  The  child  is  at  first  languid  and 
unfit  for  any  exertion,  but  brightens  up  somewhat 
after  the  first  two  or  three  days.  There  is  a  great 
tendency  for  the  catarrh  to  pass  downward  to 
the  bronchi  and  the  lungs;  and  this  constitutes 
the  chief  danger  of  nasal  catarrh  in  childhood. 
Recurring  colds  must,  therefore,  not  be  treated 
lightly;  they  may  lead  to  bronchitis  or  pneumonia. 
A  cause  must  be  carefully  sought  in  ill-ventilated 
and  overheated  nurseries,  in  stomach  troubles, 
in  cold  extremities,  in  injudicious  exposure.  And 
the  discovered  cause  must  be  removed  before  any 
treatment  will  avail. 

ADENOIDS 

Some  years  ago,  on  the  metropolitan  East  Side, 
where   sixty-odd   languages   are   represented   and 

74 


CHILDHOOD 

where  are  the  most  crowded  blocks  of  houses  in 
the  whole  world,  including  such  places  as  Peking 
and  Calcutta,  there  was  a  riot  among  the  mothers 
and  aunts  and  grandmothers  of  the  school  children. 
Those  women  had  somehow  got  it  into  their  heads 
that  the  "school  doctors"  were  cutting  the  throats 
of  their  children.  Here  was  a  notion  which  the 
thirteenth  century  would  have  been  ashamed  to 
entertain;  and  yet,  when  a  crowd  of  women  get 
together,  any  idea,  however  absurd,  is  likely  to 
lead  to  extremes  such  as  no  mere  man  can  foresee. 
And  if  you  do  not  believe  this,  read  Le  Bon's 
book,  The  Crowd,  A  Study  of  the  Popular  Mind. 

Here  is  just  what  those  physicians  were  doing. 
They  were  examining  the  throats  of  the  children 
and  they  were  writing  on  cards :  Mrs.  Hasenpfeffer 
or  Mrs.  O'Shaughnessey  or  Mrs.  Bacigalupo  or 
Mrs.  Rosenstein,  or  whatever  the  mother's  name 
might  be,  "Your  child  has  adenoids.  You  should 
have  this  ailment  attended  to.  If  you  cannot 
afford  to  go  to  a  doctor  of  your  own,  you  should 
take  your  child  to  a  hospital."  And  that  brought  on 
the  riot.  All  of  which  goes  to  show  how  doctors  are 
misunderstood  in  this  world,  and  why,  even  though 
they  do  write  books  on  how  to  live  longer,  they 
die  younger — much  younger — than  clergymen  and 
bankers  and  publishers  and  other  people  like  that. 

Adenoids  are  soft  "lymphoid"  vegetations  or 
overgrowths,  bleeding  readily.  They  lie  far  back 
of  the  nose  and  in  the  vault  of  the  throat;  some- 
times they  come  down  so  far  that  they  can  be 
seen  as  gelatinous  masses  at  the  back  of  the  mouth, 
behind  the  "tab"  or  uvula.  They  are  found  in 
the  "post  nasal  space"  in  all  ages,  even  in  the 

75 


WHY  DIE  SO  YOUNG? 

newly  born.  The  infant  snuffles  loudly  and  there 
is  often  considerable  nasal  discharge.  The  trouble 
may  interfere  greatly  with  suckling,  and  the 
poor  infant,  older  children  as  well,  are  liable  to 
attacks  of  suffocation  during  sleep  and  to  night 
terrors.  Indeed,  a  lot  of  "grinding  or  gritting  of 
the  teeth,"  which  is  generally  attributed  to  other 
causes,  may  really  be  due  to  adenoids.  Such 
children  are  prone  to  vomiting.  The  expression  on 
the  face  of  a  child  suffering  from  adenoids  is  un- 
mistakable. The  child  has  constantly  either  to 
blow  its  nose  or  to  hawk  and  spit  out;  the  nostrils 
are  round  and  dilated  (or  in  older  children  flattened 
across — just  mere  slits);  the  face  is  pale;  the 
child  is  manifestly  poor  blooded;  and,  of  course, 
he  is  a  mouth -breather,  his  jaw  is  dropped;  his 
expression  is  dull  and  vacant,  even  idiotic.  These 
symptoms  may  appear  only  after  an  attack  of 
any  childhood  infection.  The  lips  and  tongue  are 
dry.  There  is  much  earache,  and  in  consequence 
"running  ears."  The  eyes  are  watery  and  in- 
flamed, and  the  nasal  discharges  may  cause  sores 
of  the  upper  lip.  The  taste  and  smell  are  deficient. 
And  there  is  likely  to  be  bronchitis  with  a  barking 
cough.    Habit  spasm  is  observed  in  some  cases. 

The  consequences  of  adenoids  are:  mouth  breath- 
ing and  narrow-chestedness,  and  thus  poor  lung 
expansion,  by  which  the  child  becomes  starved  for 
oxygen  and  an  easy  candidate  for  consumption; 
snoring;  open-mouthedness,  or  vacant,  dull  ex- 
pression of  the  face;  unpleasant,  toneless  modifi- 
cations of  a  naturally  pleasant  voice,  such  as  the 
"nasal    twang";     inability    to   pronounce   certain 

letters;     earache   and   other   ear   infections,    even 

70 


CHILDHOOD 

deafness,  by  shutting  up  the  Eustachian  tube, 
which  should  in  health  always  be  open;  mental 
deficiency,  making  a  dunce  of  a  naturally  bright 
child;  frequent  attacks  of  coryza  (nasal  catarrh); 
nosebleed;  irregular  tooth  and  jaw  formation; 
stunted  growth;  convulsions,  and  a  general  nervous 
and  perturbed  condition,  so  that  an  ordinarily 
good  child  is  unjustly  accused  of  wanton  mis- 
behavior or  of  crass  perversity. 

Deformities  may  appear.  The  natural  and 
uniform  development  of  the  face  is  hindered, 
leading  to  the  narrow  jaw  with  crowded  teeth 
and  the  high-arched  palate.  And  it  takes  the 
highest  skill  of  the  orthodontist  to  correct  those 
jaw  deformities.  In  the  chest  there  is  likely  to  be 
alteration  of  shape;  in  some  cases  the  pigeon,  or  the 
keel  breast,  but  in  most  cases  the  formation  of  a 
hollow  at  the  lower  end  of  a  breastplate,  which  the 
child  makes  obvious  when  the  parts  are  sucked 
in  with  each  inspiration. 

ENLARGED   TONSILS 

When  enlarged  tonsils  are  found  in  children, 
adenoids  are  sure  to  be  present  also  in  90  per 
cent  of  the  cases.  Tonsils  are  sometimes  en- 
larged from  birth;  but  they  usually  become  so 
by  reason  of  successive  attacks  of  tonsillitis  or 
quinsy  or  diphtheria,  scarlet  fever,  measles,  or  in 
fact  any  nose  and  throat  inflammation.  Some- 
times the  tonsils  become  so  enormous  that  they 
actually  touch  in  the  act  of  swallowing;  also  in 
such  children  there  is  the  "throaty"  voice,  as  if 
the  mouth  were  full  of  food;  and  in  some  cases 
there  is  a  dry  cough,   in  which  much  stuttering 

77 


WHY  DIE  SO  YOUNG? 

begins.  The  glands  in  the  neck  beneath  the  skin 
are  also  liable  to  become  swollen,  and  tuberculosis 
all  too  often  follows.  Besides  the  evil  due  to  the 
mechanical  obstruction  of  the  tonsils  there  is  a 
tendency  to  repeated  inflammations.  Also  the 
tonsils,  being  thus  in  a  state  of  chronic  unhealthi- 
ness,  become  rich  soil  for  many  germs,  and  most 
especially  for  the  rheumatism  germs,  to  grow  and 
multiply  in.  These  germs  get  from  the  tonsils  to 
the  lymph  channels,  thence  into  the  circulation, 
and  so  invade  the  heart,  the  joints,  and  many 
other  precious  tissues  of  the  body.  Such  poor 
children  are  always  catching  cold.  Almost  all 
deafness  begins  that  way. 

Taking  it  all  in  all,  then,  by  far  the  best  thing 
to  do  with  adenoids  and  enlarged  tonsils  is  an 
operation  (or  pair  of  operations) .  These  are  quickly 
performed,  and  the  relief  is  so  great,  so  immediate, 
so  salutary  that  a  parent  who  would  think  twice 
about  having  it  done  would  be  blameworthy  in  the 
extreme.  The  child  breathes  freely  at  once  and  is 
again  able  to  enjoy  its  food  without  choking.  Opera- 
tion as  early  as  the  third  month  in  infancy  is  usual. 

In  addition  to  the  removal  of  the  adenoids  and 
the  enlarged  tonsils  the  doctor  may  later  have  to 
remove  polypi  from  the  nose,  to  straighten  a  per- 
haps crooked  septum,  or  the  like. 

, 

ST.    VITUS  S   DANCE 

Of  the  nervous  disorders  of  children,  the  most 
frequent  is  chorea  or  St.  Vitus's  dance.  The  child 
shows  local  or  general  irregular  twitching  and  other 
peculiar  muscular  movements.  Some  of  these  lat- 
ter are  volitional;  others  are  involuntary  and  can- 

78 


CHILDHOOD 

not  be  controlled.  Many  involuntary  movements 
are  imitative.  One  child  sees  another  twitching 
its  eyelids  or  twisting  its  head  in  an  odd  way;  and 
such  is  the  power  of  suggestion  that  it,  in  turn, 
displays  the  same  movements,  and  then  communi- 
cates these  to  other  children,  until  a  veritable 
psychic  epidemic  is  on. 

The  peculiar  movements  which  can  be  controlled 
are  absent  when  the  affected  child  is  at  rest,  as 
in  sleep  or  when  its  attention  can  be  successfully 
averted.  Fright,  injury,  worry,  eyestrain  are  real 
causes.  Chorea  often  complicates  or  follows  in- 
fectious fevers,  especially  heart  disease  and  rheu- 
matism. Irritability  of  temper,  anaemia,  poor  ap- 
petite, and  difficulty  with  the  digestive  tract  may 
accompany  the  ailment.  A  child  who  has  had 
convulsions  becomes  easily  prone.  Choreic  move- 
ments due  to  suggestion  can  be  corrected  and 
done  away  with  by  discipline  and  removal  of  the 
suggestions.  Real  St.  Vitus's  dance,  due  to  struc- 
tural lesions,  is  remediable  within  two  months,  but 
it  is  likely  to  recur.  The  outlook  for  such  a  child 
is  usually  good. 

A  child  suffering  thus  must  have  rest;  over- 
exertion must  be  avoided.  The  fitting  of  proper 
glasses  may  be  necessary.  Tea,  coffee,  candy,  and 
sweets  in  general  must  be  interdicted.  Compli- 
cations must  be  well  considered.  Most  cases  need 
the  building  up  of  the  general  health  and  the  right 
disciplinary  regime. 

NIGHT   TERRORS 

Night  terrors  in  children  may  be  the  forerunner 
of  mild  epilepsy  or  St.  Vitus's  dance.    Such  little 

79 


WHY  DIE  SO  YOUNG? 

sufferers  awake  in  vague,  wild  alarm,  scream, 
cling  to  the  mother,  but  apparently  fail  to  recognize 
anyone  and  cannot  at  once  be  quieted  and  re- 
assured. After  a  few  minutes  the  excitement 
spontaneously  subsides  and  the  child  returns  to 
sleep,  without  recollecting  the  attack  in  the  morn- 
ing. During  its  terror  it  may  run  from  the  room 
or  climb  upon  the  furniture  in  a  wild  attempt  to 
escape  the  figment  of  its  dreams.  Often  the  cry 
implies  a  fear  of  being  caught  by  some  hideous 
person  or  by  some  wild  animal. 

True  night  terrors  are  of  somewhat  serious 
import.  They  certainly  indicate  an  unstable 
constitution.  Sometimes  they  are  induced  by 
difficulty  in  breathing  because  of  adenoids  or 
bronchitis  or  laryngitis  or  weak  heart  or  general 
weakness.  They  may,  however,  mean  only  night- 
mare— a  kind  of  vivid  dream  usually  traceable  to 
indigestion,  to  bad  ventilation,  to  some  previous 
terrifying  experience,  or  to  mental  shock.  The 
child  has  a  feeling  of  great  weight  on  the  chest,  of 
suffocation,  or  of  falling;  it  then  suspends  respira- 
tion or  makes  distressing  inspiration  sounds  and 
awakes  with  a  start  or  in  a  wild  fright. 

TANTRUMS 

Children  have  tantrums  either  on  account  of 
poor  training  or  of  some  physical  ailment.  The 
first  of  these  causes  is  not  in  the  physician's  prov- 
ince, although  in  many  such  cases  the  family 
doctor  is  supposed  to  act  in  the  place  of  the  father, 
mother,  nurse,  half  a  dozen  relatives,  and  not  a 
few  neighbors  besides.     To  be  quite  frank,  when 

80 


CHILDHOOD 

we  come  upon  a  child  violent  or  resorting  to 
naughtiness  to  gain  its  ends,  we,  in  many  cases, 
find  that  the  parent,  especially  the  mother,  is 
herself  nervous  and  lacking  in  self-control,  cannot 
endure  having  the  child  cry,  and  thinks  that 
affection  is  best  expressed  in  terms  of  unlimited 
indulgence;  there  has  been  failure  to  teach  the 
baby,  from  its  birth,  obedience  to  law  and  order, 
and  the  child  soon  learns  that  all  it  has  to  do  to 
attract  attention  is  to  kick,  scream,  or  hold  its 
breath,  and  that  then  it  will  get  what  it  wants. 

Such  a  child  should  be  taken  to  the  family 
doctor  for  careful  examination  and  removal  of 
the  causes  in  the  given  case.  Thus  will  a  vast 
amount  of  perversity  later  in  life  be  avoided. 

Other  physical  defects  that  might  make  a 
child  irritable,  neurotic,  and  perhaps  ungovernable 
are  eyestrain,  adenoids,  enlarged  and  unhealthy 
tonsils,  imperfect  teeth,  poor  nutrition,  and  un- 
hygienic living  generally.  It  will  not  do  just  to 
say  the  child  has  nerves  and  ask  the  doctor  to 
give  him  something  for  them.  The  reason  for 
tantrums  must  be  found  in  each  case;  and  then 
intelligent  remediable  action  must  be  taken. 

MENTAL  DEFECTS 

The  feeble-minded  are  graded  as  follows:  Idiots 
(those  of  least  mentality) ;  imbeciles  (those  of  next 
higher  grade);  and  morons  (those  coming  pretty 
nearly  to  the  normal  type  of  mind).  In  general 
terms  the  idiot  never  reaches  the  plane  of  spoken 
language;  the  imbecile  understands  spoken 
language  and  talks  in  various  degrees  of  fluency; 

81 


WHY  DIE  SO  YOUNG? 

the  moron  can  speak  and  is  capable  of  learning  to 
read  and  write.  There  was,  however,  up  to  the 
use  of  the  system  devised  by  Doctor  Binet  of 
Paris,  no  way  of  clearly  defining  these  types  of 
feeble-mindedness.  His  tests  were  based  on  exami- 
nations of  groups  of  children  aged  from  three  up 
to  twelve  years.  The  idiots  have  only  the  intelli- 
gence of  an  infant  of  one  to  two  years;  their 
intelligence  may  be  practically  nil  and  they  are  not 
classified  on  the  Binet  scale.  The  imbeciles  corre- 
spond to  the  age  groups  from  three  to  seven.  The 
morons  to  the  age  groups  from  eight  to  twelve 
years,  inclusive. 

One  may  speak  also  of  the  low-,  the  middle-,  and 
the  high-grade  moron;  and  of  the  low-grade, 
middle,  average,  and  high-grade  normal.  Most 
of  the  abnormal  mentality  which  so  grievously 
troubles  civilization  lies,  not  so  much  with  idiocy 
and  imbecility  (mental  conditions  obviously  dis- 
eased), as  with  the  cases  that  align  themselves  on 
the  border  line  between  the  high-grade  moron 
(in  the  Greek  "a  silly  person")  and  the  low  grade 
normal — the  demifous — of  which  more  in  another 
place. 

Take  any  feeble-minded  person,  adult  or  child, 
and  apply  to  him  the  following  five  tests  for  a 
normal  child  of  three:  Point  to  his  nose  and  mouth; 
repeat  two  digits  (as  7  and  9);  enumerate  objects 
in  a  picture  (as  dog  or  cat,  lady,  house);  give 
family  name  (Smith  or  Jones);  repeat  a  sentence 
of  five  or  six  syllables  ("I  am  cold  and  hungry"). 
If  a  feeble-minded  person  can  go  correctly  through 
these  tests,  but  no  more,  then  his  intelligence,  his 
mental  age,  is  that  of  a  child  of  three  years. 

82 


CHILDHOOD 

The  examiner  of  school  children  considers  a 
child  regular  of  intelligence  if  its  mental  capacity 
is  equal  to  its  age;  advanced  (precocious),  if  it  has 
an  intelligence  one  or  two  years  greater  than  its 
age;  retarded,  if  it  has  an  intelligence  one  or  two 
years  inferior  to  its  age.  No  child  is  called  de- 
fective unless  his  retardation  of  intelligence  amounts 
to  more  than  two  years. 

By  means  of  the  Binet  scale,  then,  one  can 
pick  out  retarded  children,  give  them  special 
training,  and  make  of  them,  before  they  reach 
adult  years,  fairly  normal  citizens,  fit  to  take  up 
life's  duties  and  responsibilities.  By  doing  this 
civilization  will  not  have  to  cope  with  a  vast 
amount  of  viciousness,  will  not  have  to  make  vast 
expenditures  for  charitable  and  reformatory  pur- 
poses. 

Can  we  help  the  feeble-minded?  We  cannot 
do  so  in  the  case  of  the  idiot,  who  has  not  developed 
normally,  in  whom  the  cells  composing  the  brain 
are  not  normally  arranged  or  constructed,  or  when 
by  reason  of  some  grave  disease  brain  tissue  has 
been  destroyed,  especially  brain  cortex,  which  is 
made  up  for  the  most  part  of  brain  cells,  its  gray 
matter.  The  brain  is  the  machinery  by  means  of 
which  thought  is  produced;  it  is  not  in  itself 
mind;  it  is  the  vehicle  by  which  mind  manifests 
itself.  What  mind  itself  is  who  shall  say?  When 
the  thought  machinery  is  wholly  destroyed,  its  prod- 
uct must  cease;  when  it  is  partly  destroyed,  its 
product  must  be  deficient  in  quantity,  or  in  quality, 
or  in  both.  And  unfortunately  the  brain  is  the 
only  part  of  the  human  mechanism  which  cannot  be 
regenerated  or  replaced  either  in  whole  or  in  part. 

83 


WHY  DIE  SO  YOUNG? 

But  when  the  mental  deficiency  is  due  to  the 
improper  response  of  the  central  nervous  system 
to  the  impressions  from  without  the  body,  to 
functional  and  not  to  structural  impairment,  the 
brain  being  anatomically  well  enough,  we  may 
hope  to  cure  the  mental  deficiency.  All  living  is 
indeed  the  right  adjustment  of  internal  relations 
to  our  external  relations.  From  the  materialistic 
point  of  view,  anyway,  life  is  a  matter  of  our 
adaptability  to  our  environment.  And  when  that 
is  right,  good  health  and  long  life  are  in  great 
measure  assured. 

MORALITY   AND    PHYSICAL   DEFECTS 

Much  consideration  has  of  recent  years  been  given 
to  the  relation  which  physical  abnormalities  may 
bear  to  juvenile  delinquencies.  A  child's  antisocial 
tendencies  may  have  been  due  to  parental  neglect 
or  to  hopelessly  adverse  environment;  or  it  may 
be  generally  undeveloped,  or  suffering  from  patent 
physical  defects,  or  grossly  undernourished,  or 
its  special  senses  may  be  most  grievously  at  fault. 
If  we  accept  the  definition  of  morality  as  being  the 
crystallization  of  natural  law  we  have  to  conclude 
that  many  a  child,  unfortunate  as  to  its  physical 
departures  from  nature's  norm,  will  have  to  be 
considered  irresponsible  should  it  have  committed 
offenses  against  the  moral  law.  In  any  event  it 
has  been  justly  concluded  that  juvenile  offenders, 
before  they  are  branded  real  criminals,  should 
undergo  exhaustive  medical  examination.  Many 
a  perverse  child,  by  the  rectification  of  physical 
defects,    found   at   such   examinations,   has   been 

84 


CHILDHOOD 

rescued  for  splendid  manhood  and  virtuous  woman- 
hood and  from  the  pauperism,  the  vagrancy,  the 
social  degradation,  and  the  jail,  which  would  in 
other  eras  have  been  its  life  portion. 

I  happened  one  day  to  have  accompanied  an 
eminent  alienist  to  a  religious  service  conducted 
in  a  prison  chapel.  My  colleague  unobtrusively 
indicated  one  prisoner,  whispering  to  me:  "That 
man  has  no  business  in  jail;  he  is  a  pronounced 
microcephalic  and  has  not  the  remotest  notion  of 
the  difference  between  right  and  wrong.  This  other 
is  a  scaphocephaly,  wherefore  he  is  unjustly 
suffering  confinement  in  a  prison.  That  woman 
has  a  tower-shaped  head  and  is  irresponsible."  And 
so  on.  Whatever  institution  they  should  have 
been  in,  the  prison  should  not  have  housed  them; 
for  they  were  so  born  that  their  normal  natures 
were  either  absent  or  perverted. 

For  example,  a  boy  was  sentenced  to  a  long 
term  in  Sing  Sing  prison — the  worst  boy,  the 
judge  declared,  that  had  ever  come  before  him. 
Certainly  he  had  a  bad  enough  record  and  was  not 
at  all  a  pleasing  youth.  He  had  served  nine  times 
in  various  reformatories  for  boys.  Among  the 
long  list  of  his  offenses  was  a  savage  attack  on  his 
mother  and  the  heaving  of  a  lighted  lamp  at  his 
father.  Yet  there  may  have  been  at  least  mitigat- 
ing circumstances — the  law  is  always  supposed  to 
make  allowances  for  such — of  a  physical  sort.  Some 
hereditary  anatomical  and  functional  stigmata  may 
have  completely  blunted  the  moral  sense.  The 
first  incarceration  of  such  perverse  boys  all  too 
frequently  means  practically  lifelong  imprisonment, 
with  intermittent  periods  of  freedom,  which  are 

7  85 


WHY  DIE  SO  YOUNG? 

punctuated  by  fresh  crimes.  In  such  a  boy  marked 
refractive  errors  may  have  made  study  a  torture 
rather  than  a  pleasure,  the  acquisition  of  sub- 
stantial knowledge  a  sheer  impossibility;  he  may 
have  seemed  inattentive  when  in  reality  his  hearing 
was  hopelessly  defective,  or  when  adenoids  were 
inducing  oxygen  starvation  and  abnormal  metab- 
olism. There  may  have  been  depressed  fracture, 
inducing  the  petit  mat  or  slight  epilepsy. 

We  have  found  that,  quite  apart  from  criminal 
tendencies,  defects  in  children  are  all  too  frequent. 
And  fortunately  the  most  of  them  are  remediable. 
Society  should  and  does  now,  in  its  acquired 
wisdom,  recognize  its  duty  toward  the  physically 
defective  child;  its  own  welfare  demands  that  it 
should,  and  the  duty  is  not  difficult  to  fulfill.  By 
eradicating  palpable  and  manifest  defects  it  enlists 
the  unblamable  vicious  among  its  useful  and 
grateful  members.  This  course  is  better  from  a 
merely  utilitarian  viewpoint  than  making  enemies 
of  them  by  unjust  imprisonments,  during  which 
they  will  brood  upon  the  world's  injustices  and 
will  invent  ways  of  promoting  social  upheavals  and 
of  destroying  our  civilization. 


Ill 

YOUTH 

"And  then  the  lover, 

Sighing  like  a  furnace,  with  a  woeful  ballad 

Made  to  his  mistress*  eyebrows." 

"the  soul's  awakening" 

THERE  are  two  paintings  which  in  my  mind's 
eye,  long  ago,  I  placed  side  by  side,  by  reason 
that  they  glorify  each  a  complemental,  a  reciprocal 
phase  in  life — man's  and  woman's  third  stage. 
They  are  both  very  familiar  pictures  and  the 
reader  will  at  once  recognize  my  sketch  of  them. 
They  have  to  do  with  early  manhood  and  with 
maidenhood;  with  the  time  when  poetry,  music, 
flowers,  perfumes,  the  blessed  sunshine,  and  the 
heretofore  latent  instinct  to  love,  and  the  power 
to  inspire  love,  are  gloriously  dominant;  when 
sentiments  ring  true;  when  the  fingers  are  snapped 
contemptuously  in  the  face  of  fate;  when  circum- 
stance has  not  yet  affected  character;  when  there 
is — as  yet — never  a  thought  of  subordinating 
youth's  precious  ideals  to  civilization's  mean  and 
mercenary  interests. 

The  one  of  these  pictures  is  called  "The  Soul's 
Awakening."  I  do  not  know  whether  Zant,  the 
painter,  named  it  thus.  Perhaps  it  is  in  this  respect, 
like    the    "Moonlight    Sonata"    or    the    "Spring 

87 


WHY  DIE  SO  YOUNG? 

Song,"  to  neither  of  which  Beethoven  or  Men- 
delssohn gave  those  titles.  Anyway,  Zant's  painting 
is  to  my  mind  wonderfully  well  entitled.  We 
contemplate  a  very  young  girl,  whose  family  and 
friends  had  but  a  little  while  before  been  speaking 
of  her  as  a  child.  She  is  now  a  woman.  But  she 
has  thus  far  hardly  passed  through  the  gateway 
into  that  marvelous  field.  Its  wonders  are  very 
new  to  her;  its  strangeness  very  entrancing. 
Clearly  she  has  entered  on  ways  most  lovely. 
Such  a  field  she  dreamed  of  in  childhood;  in  her 
little-girl  day  musings  there  were  vague  foreshadow- 
ings  of  its  beauties  and  of  its  rich  comfortableness. 
But  her  dreamings  never  reached  the  realization 
now  vouchsafed  her. 

Yet  even  with  her  hand,  tremulous  as  the 
body  of  a  little  bird,  on  the  gate  opening  into  that 
field,  she  can  comprehend  that,  with  all  things 
wholesome  and  pleasurable,  there  must  come 
responsibilities  and  compensating  cares.  And 
although  she  has  no  fear,  courageous  emotions  are 
certainly  aroused  in  her;  dimly,  perhaps  only 
subconsciously,  she  appreciates  that  the  heritage 
of  anxiety  and  suffering  which  her  mother  experi- 
enced in  her  behalf  must  now  soon  become  her 
own.  Wifehood  and  motherhood  are  now,  in  her 
turn,  to  become  her  portion. 

In  Zant's  exquisite  picture  the  courage  and  the 
trust  lie  mostly  in  the  eyes,  which  are  large  and 
clear,  liquid  and  deep  and  most  frank;  in  them 
all  the  fearlessness  that  will  be  needed  is  to  be 
found.  Then,  besides  those  organs,  that  superb 
painter  has  presented  other  and  most  ingratiating 
and  winsome  features,  all  with  infinitely  gentle 

88 


YOUTH 

touch.  And  the  as  yet  immature  figure  is  most 
delicately  protrayed;  and  last  of  all  the  luxuriant 
hair  caressing  softly  the  head  and  shoulders. 
What  poet's  heart  this  Zant  must  have,  if  he  still 
lives  among  us;  what  a  veritable  seer  he  must  be, 
to  have  been  able  to  grasp,  as  he  does,  the  inner- 
most, the  fundamental  in  life. 

The  other  painting  which  I  have  in  mind  is 
Abbey's  "Sir  Galahad,"  whose  ideal  was 

"To  love  one  maiden  only,  cleave  to  her, 
And  worship  her  by  years  of  noble  deeds." 

We  are  all  familiar  with  the  painting  and  the 
sentiment.  And  it  is  an  ideal  which  I  have  found 
realized  hundreds  of  times  during  my  professional 
life,  but  never  before  so  manifestly  as  during  the 
recent  demobilization  period,  when  I  had  the  great 
good  fortune  to  examine,  before  their  return  to 
civil  life,  several  hundred  men,  the  most  of  them 
still  in  Uncle  Sam's  khaki  or  in  his  navy  blue.  I 
was  able  to  form  with  these  young  men  most 
pleasant  and  sympathetic  relations,  and  a  fine 
feeling  of  camaraderie. 

How  grateful  was  my  task!  And  these  Sir 
Galahads,  those  younger  brothers,  in  spirit  and 
in  truth,  of  that  chevalier  sans  peur  et  sans  reproche, 
those  young  men  who  came  back  from  their  epic 
heroisms,  from  their  soarings  into  the  empyrean, 
those  strong  and  healthy  youths  had  army  and 
navy  experiences  back  of  them  richer  than  most 
men  of  threescore  and  ten  could  boast.  Those 
splendid  young  fellows  had  well-nigh  perfect 
physiques — held  themselves  straight,  shoulders 
back,  clear  eyes,  magnificent  specimens.     Let  us 

89 


WHY  DIE  SO  YOUNG? 

take  the  sweet  with  the  bitter.  The  war  was 
horrible,  soaked  in  suffering.  But  on  the  other 
hand  the  training  for  it  and  the  actual  fighting 
for  it  made  real  men.  Captains  of  their  own 
souls  were  they;  but  especially  so  in  the  determi- 
nation to  keep  themselves  straight  for  the  marriage 
relation.  And  I  can  do  no  better  than  to  hope  that 
the  splendid  average  of  health  which  the  war  has 
produced  may  be  perpetuated,  that  in  order  for  a 
vigorous  maturity  and  a  hale  old  age,  three  pitfalls 
may  at  least  be  avoided. 

THOSE   YELLOW   FINGER  TIPS 

Tobacco  has  been  in  immense  favor  with  our 
soldiers  and  our  sailors.  It  has  been  a  comfort 
indeed  during  hardship;  the  wounded  have  found 
unspeakable  solace  in  it.  Who  would  have  spoken 
an  untoward  word  that  has  seen  the  cigarette  being 
inserted  between  the  anguished  lips  of  the  "side- 
swiped"  hero,  the  match  applied  and  then  the 
contentment  evidenced  in  what  was  left  of  his 
countenance.  Who  would  have  withheld  such 
alleviation  where  there  was  so  great  need  of  com- 
fort. But  now  the  war,  with  its  altogether  un- 
precedented sufferings,  is  over,  and  one  may 
write  something  about  tobacco  without  appearing 
to  be  a  spoilsport. 

For  adults  tobacco  may  be  wholesome,  though 
personally  I  doubt  it,  for  most  men.  But  there 
can  be  no  question  about  its  unfortunate  effect 
on  the  as  yet  immature  organism — that  of  the 
man  under  twenty-one.  Take  the  nervous  system, 
for  instance. 

90 


YOUTH 

Youths  who  smoke  no  more  than  a  pipeful  or 
two  a  day  will  tell  of  their  vertigo,  their  giddiness 
and  trembling,  the  leg  weariness  they  experience. 
They  forget  words ;  their  memory  plays  them  queer 
tricks.  Their  power  of  concentration  and  of 
associating  their  ideas,  their  ability  for  sustained 
mental  application — these  faculties  are  impaired. 
The  nicotine  has  been  poisoning  their  spinal  cords 
and  their  brain  centers,  also  the  sympathetic 
nerve  centers;  and  so  they  have  cold  and  moist 
extremities  and  their  faces  are  suffused  with  a 
clammy  pallor. 

Then  the  nicotine  at  first  powerfully  increases 
the  blood  pressure,  and  so  slows  the  circulation. 
But  soon  the  heart  and  vessels  grow  tired  of  the 
unwonted  strain  and  then  come  rapid  and  inter- 
mittent pulse,  palpitation,  and  pain  about  the 
heart,  oftentimes  severe,  and  sharp  smoker's  angi- 
na. The  blood  pressure  is  found  to  be  subnormal, 
indicating  bodily  weakness.  And  a  blood  test  will 
demonstrate  ansemia — blood  poverty. 

Digestion  is  often  impaired.  One  doesn't,  of 
course,  feel  quite  so  badly  as  after  "that  first 
smoke."  It  is  just  that  the  agony  is  now  attenuated 
and  spread  over  months  and  years.  Much  saliva 
is  perhaps  subconsciously  swallowed  by  smokers 
who  do  not  spit,  and  by  chewers  of  tobacco. 
Upon  all  this  flatulence,  nausea,  and  heartburn 
supervene. 

Tobacco  induces  catarrh  of  the  nose  and  throat; 
and  no  catarrh,  from  whatever  cause,  is  curable  in 
a  smoker.  Asthma  is  not  rare  in  under-age  smokers, 
who  become  markedly  short-winded.  The  most 
injurious  way  of  using  tobacco  is  the  cigarette, 

91 


WHY  DIE  SO  YOUNG? 

largely  because  the  fumes  are  inhaled  and  also 
because  of  the  temptation  to  use  many  cigarettes 
and  to  do  so  incessantly,  sometimes  only  to  be 
companionable. 

As  I  have  observed,  tobacco  may  be  wholesome 
for  the  man  in  the  prime  of  life.  But  the  body 
of  the  youth  is  fresh  and  rich  in  reserve  forces, 
in  the  factors  of  safety  about  which  I  shall  write 
later;  and  it  really  needs  neither  tobacco  nor  any 
other  stimulant.  Y^oung  men,  certainly  those 
under  age,  had  better  cut  it  out. 

JOHN   BARLEYCORN 

It  is  easily  within  the  recollection  of  any  adult 
how,  years  before  the  war  just  ended,  sailors  on 
shore  leave  from  our  ships  in  port  were  reeling 
through  our  thoroughfares,  making  themselves  most 
obnoxious,  quarrelsome,  if  not  fighting,  and  terror- 
izingly  drunk. 

During  an  evening's  enjoyment  of  the  movies 
I  found  myself  sitting  behind  some  half  a  dozen 
boys  in  blue.  A  more  prepossessing,  a  more 
likable  lot  of  youngsters  —  clean  shaven,  hair 
neatly  combed,  nattily  uniformed — it  would  be 
hard  to  find  together  in  any  town,  in  any  club- 
room,  at  any  church  sociable.  Oh,  the  adorable 
young  men  the  war  has  been  responsible  for! 

They  sat  complacent,  did  those  boys,  while  the 
audience  grew  hoarse  over  the  naval  pictures. 
They  were  feeling,  no  doubt,  "Oh  yes,  we  did  it, 
just  as  you  are  seeing  it;  but  it  was  all  in  the  day's 
work,  so  what's  the  use  in  making  a  fuss  about  it?" 
They  appreciated  the  topical  reviews;  they  chortled 

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over  the  comics ;  and  they  snuffled,  pulled  out  their 
handkerchiefs,  and  surreptitiously  wiped  the  corners 
of  their  eyes,  along  with  everybody  else  (the  writer 
included)  when  a  movie  queen  "turned  on  the 
sob  stuff." 

A  lady  seated  in  front  of  these  boys  had  some 
trouble  adjusting  her  cloak  over  her  shoulders. 
One  of  them  leaned  forward  and  helped  her  as 
deftly  and  as  gently  as  could  any  other  cavalier, 
and  was  graciously,  in  the  like  good  spirit,  thanked 
by  her.  And  those  wholly  admirable  gentlemen 
were  constantly  passing  among  themselves — a 
flask?  No.  A  plug?  No.  A  box  of  bonbons.  How 
marvelous  a  change  from  the  not  distant  past! 
From  the  days  when  intemperance  was  so  rife 
among  soldiers  and  sailors  everywhere,  when  the 
intemperate  man  in  unifrom  was  so  frequently  a 
public  scandal,  "a  curse  to  his  companions,  the 
first  in  a  mutiny,  the  last  in  a  battle."  It  is  most 
gratifying  to  observe  how  alcoholism  has  been 
going  down  and  out  of  fashion  since  the  war.  And 
what  indeed  has  been  the  effect  of  alcohol  on 
youthful  organisms? 

There  are  many  substances  to  be  found  in 
nature  which  some  doctor  has  well  termed  the 
"paratriptics,"  the  savings  bank  of  the  bodily 
tissues.  Probably  every  tribe  or  people  that 
discoverers  or  explorers  have  ever  visited  has 
found  its  use  for  one  or  another  of  these:  For 
instance,  the  Calabar  bean,  cocoa,  moxie,  the 
arsenic  of  the  Tyrol,  strychnine,  the  gentian  of  the 
Alps,  the  Peruvian  cinchona,  India  hemp,  alcohol, 
tea,  coffee,  tobacco.  The  best  reason  for  saying 
that  these  things  are  beneficial  when  judiciously 

93 


WHY  DIE  SO  YOUNG? 

used  is  that  the  demand  for  them  is  not  to  be 
denied,  is  world  wide,  and  not  wholly  explainable 
on  the  basis  of  human  depravity;  and  they  certainly 
do  tide  an  exhausted  or  misused  organism  over 
physical  and  mental  crises.  And  since  our  human 
civilization  seems  to  be  such  that  abnormal  wear 
and  tear  is  often  unavoidable,  there  is  a  logical 
place  for  the  paratriptics.  Most  of  them  are 
unpalatable  and  have  to  be  got  used  to.  Doctors 
are  constantly  prescribing  them  for  their  tonic 
effects;  their  use  is  certainly  "indicated"  for  the 
elderly  and  the  debilitated. 

However,  the  body  of  the  growing  boy,  the 
youth,  and  the  young  man  are  fresh  and  rich  in 
reserves,  quick  in  and  of  themselves,  and  without 
the  aid  of  paratriptics,  or  any  rehabilitating  agency 
to  restore  themselves.  Especially  in  these  periods 
of  life  is  alcohol  altogether  unnecessary,  even 
"contraindicated"  as  the  doctors  say.  And  it 
is  most  gratifying  to  observe  that  this  fact  is 
becoming  very  generally  accepted  by  athletic 
organizations  and  college  students.  To  this  effect 
are  reports  from  Yale,  Harvard,  Princeton,  Cornell, 
the  Universities  of  Minnesota,  Wisconsin,  Chicago, 
California.  Connie  Mack,  manager  of  the  Phila- 
delphia Athletics,  the  year  his  team  won  the 
world's  championship,  said  that  fifteen  of  his 
twenty-five  players  "did  not  even  know  the  taste 
of  liquor."  Ted  Coy,  a  Yale  captain  of  a  few 
years  ago,  put  the  ban  on  all  forms  of  alcoholic 
drinks  for  his  team. 

And  now,  by  way  of  introducing  my  third  point, 
I  have  to  state  the  well-established  fact  that  in 
the  past  fully  70  per  cent  of  the  ghastly  venereal 

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diseases  (having  for  their  aftermath  more  than 
half  of  all  the  suffering  and  surgical  intervention 
which  married  women  have  later  in  their  lives  to 
endure)  have  been  contracted  under  the  influence 
of  alcohol  and  by  young  men  under  twenty-five. 

HE   THAT   RULETH   HIS   SPIRIT 

One  of  the  most  grateful  of  the  war's  by-products 
is  the  proof  it  has  furnished  that  sexual  intercourse 
is  not  essential  to  the  young  man's  health.  Of 
course,  there  are  those  who  have  fallen  by  the 
wayside.  But  by  far  the  most  of  Uncle  Sam's 
boys,  I  am  convinced,  have  during  their  training 
been  clean  hearted  and  have  come  back  from 
"over  there"  bearmg  upon  their  bodies  no  scars 
save  those  earned  in  honorable  warfare.  This  has 
been  largely  because  of  the  fine  spirit  among  those 
men  of  ours,  aided  by  the  education  given  by  our 
army  surgeons;  and  by  reason  of  the  inexorable 
military  discipline  with  regard  to  sexual  diseases 
that  was  instituted  and  was  throughout  constantly 
maintained. 

And  yet  it  has  always  been  the  truth  that, 
although  continence  is  harder  for  the  male  by  reason 
that  nature  has  made  him  the  aggressive  factor, 
yet  there  is  no  essential  occasion  for  a  double 
standard.  And  although  doctors  have  treated 
uncountable  young  men  for  disease  the  result  of 
incontinence,  they  have  yet  to  treat  anyone  for  a 
disease  by  reason  of  continence. 

The  trainers  of  college  athletes,  of  professional 
and  club  contesters,  have  ever  required  their 
charges  to  "keep  straight,"  at  least  during  train- 

95 


WHY  DIE  SO  YOUNG? 

ing;  this  has  made  them  superlative  specimens  of 
manhood.  Soldiers,  hunters,  sailors,  explorers,  for 
many  months,  for  years  together,  never  know  any 
woman;  and  they  are  the  noblest  as  well  as  the 
most  virile  of  mankind.  Alexander  the  Great  was 
in  nothing  else  so  great  as  that,  in  his  youth,  at 
least,  he  despised  and  renounced  courtesans. 
Ruling  his  spirit,  he  was  consequently  able  for 
the  lesser  business  of  taking  cities.  Our  men  of 
the  greatest  stamina  and  intellectual  vigor — 
scholars,  statesmen,  world  compellers,  thinkers  of 
epic  thoughts — have  ever  felt  fitter  for  their 
monumental  works  when  entirely  free  of  sexual 
bondage.  Sexual  restraint  makes  for  strong  and 
noble,  men.  There  is  no  manlier  body  of  men 
than  the  Roman  Catholic  clergy,  who  vow  and 
practice  chastity.  Every  man  that  striveth  for 
the  mastery  is  temperate  in  all  things,  but  es- 
pecially in  this  relation. 

The  main  factor  which  distinguishes  us  from 
other  creations  is  the  Almighty's  precious  gift  of 
the  human  will.  Those  who  are  content  to  hold 
this  gift  without  value,  who  will  not  be  king  of 
all  that  is  under  their  own  hats,  have  in  the  past 
brought  so  much  extreme  suffering  and  shame, 
not  only  upon  themselves,  but  also  upon  others 
altogether  innocent,  that  the  venereal  plagues 
have  rightly  been  termed  by  physicians  the  familial 
diseases. 

And  as  we  who  read  this  book  are  all  for  the 
healthful  and  the  long  life,  we  may  here  anticipate 
our  Seventh  Age  by  considering  the  following, 
which  Shakespeare  put  into  the  mouth  of  "Old 
Adam": 

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'Though  I  look  old,  yet  I  am  strong  and  lusty; 
For  in  my  youth  I  never  did  apply 
Hot  and  rebellious  liquors  in  my  blood, 
Nor  did  I  with  unbashful  forehead  woo 
The  means  of  weakness  and  debility; 
Therefore  mine  age  is  as  a  lusty  winter, 
Frosty,  but  kindly." 


THE   COMMON   COLD 

"Could  the  sum  total  of  suffering,  inconvenience, 

sequelae,  and  economic  loss  resulting  from  common 

colds  be  obtained,  those  infections  would  at  once 

be  promoted  from  the  trivial  into  the  ranks  of  the 

serious  diseases."     Two    of    these  sequela?  alone, 

pneumonia    and    tuberculosis,     account    between 

them  for  more  than  half  of  human  mortality;   and 

of  all  the  causes  of  tuberculosis  the  most  frequent 

is  the  common  cold,  the  neglected  cold,  of  which 

one  so  carelessly  says,   "It  is  nothing  but  a  cold." 

Among  other  derivatives  of  the  common  cold  (in 

itself  the  most  frequent  of  all  human  ailments) 

are    rheumatism,    mastoid    abscess,    and    kidney, 

heart,    and    other    grave    organic    diseases.      The 

common   cold   is   more   than   a   congestion,   more 

than  a  catarrh,  more  than  an  inflammation.    It  is 

an  infection,   the  specific,   the  essential  cause  of 

which   is  one  or  other  of  several  germs,   among 

which  are  the  pneumonia,  the  rheumatism  germ, 

the  influenza  bacillus,  or  a  mixture  of  bacteria,  a 

"mixed  infection."    And  what  is  called  the  "cold" 

is   in   reality   the   infection    which   has   incubated 

through  the  implantation  of  these  germs  on  the 

congested,  the  unhealthful,  and  predisposed  mucous 

membranes  of  the  nose,  the  tonsils,  and  the  upper 

97 


WHY  DIE  SO  YOUNG? 

air  passages.  Those  tissues  can  become  congested 
and  inflamed  by  other  than  germinal  irritations, 
as  by  chemical  fumes  or  by  inhaled  metal  and 
fiber  particles,  or  there  may  be  obstructions,  as 
adenoids  or  enlarged  tonsils.  A  deflected  septum 
in  the  nose  will  occasion  a  catarrh;  irritant  exuda- 
tions of  gas  from  the  stomach  in  dyspeptics  will 
produce  nose  and  throat  catarrh;  while  increased 
acidity  of  the  blood  (acidosis)  may  inflame  the 
mucous  membranes.  Congestions  and  catarrhs 
come  about  reflexly  in  people  of  nervous  tempera- 
ments and  in  neurasthenics — those  in  whom  the 
nervous  system  is  exhausted.  Such  are  likely  to 
get  catarrh  simply  from  the  apprehension  of 
catching  cold.  But  these  causes,  not  being  bac- 
terial, not  being  germinal,  do  not  constitute  the 
infectious  and  consequently  communicable  cold. 
The  common  cold  may,  however,  be  developed  from 
them,  as  they  provide  a  rich  soil  for  the  micro- 
scopic weed  to  thrive  in. 

Exposure  to  draughts;  to  dust,  which  is  generally 
germ-laden;  to  high  winds,  which  are  generally 
dust-laden;  to  sudden  changes  of  temperature, 
such  as  obtain  in  our  Northern  states  in  the  early 
and  late  winter  weeks;  getting  chilled  and  wet  feet 
(by  far  the  worst  of  all  predispositions) — these 
factors  depress  the  vitality  and  thus  make  the 
body  a  receptive  germ  host.  Arctic  explorers 
rarely  come  down  with  colds  until  they  return  to 
civilization,  where  the  germs  are,  and  become  cave 
dwellers  like  the  rest  of  us. 

Colds  seem,  indeed,  the  exclusive  privilege  of 
civilization.  Our  race,  in  all  likelihood,  did  not 
snuffle  much  until  it  began  to  build  houses,  to 

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heat  these  houses,  and  to  wear  germ-harboring 
clothes.  Then,  instead  of  a  wholesome  coping 
with  the  elements,  people  crowded  into  super- 
heated houses,  with  the  windows  nailed  down,  and 
missed  the  blessed  sunshine,  the  best  of  all  purifiers, 
of  all  disinfectants. 

"The  stove  is  a  mesmerist  that  plays  no  small 
part  in  the  reduction  of  human  beings  to  a  state  of 
idiocy.  The  mephitic  vapors  in  the  atmosphere 
of  a  crowded  room  contribute  in  no  small  degree 
to  bring  about  a  gradual  deterioration  of  intelli- 
gence." This  is  not  a  quotation  from  an  up-to- 
date  book  on  hygiene.  Balzac  wrote  it  in  a  novel 
some  seventy  years  ago.  Hibernating  in  their 
comfortable  though  devitalizing  houses,  people 
constantly  rebreathe  their  own  poisonous  and 
germ-laden  exhalations,  mingled  with  those  of  the 
family,  the  visitors,  and  such  animal  friends  as 
they  cannot  bear  to  expose  to  the  raging  elements 
without.  Those  who  would  certainly  revolt  against 
bathing  in  polluted  water  are  not  at  all  squeamish 
about  inhaling  polluted  atmospheres.  Nor  is  it 
"the  engine  drivers  and  the  firemen  who  catch 
cold,  but  the  passengers  in  the  stuffy  Pullmans 
and  the  reeking  coaches." 

A  poor  digestion  has  much  to  do  with  germ- 
breeding  catarrhs.  Eating  indigestible  food  (shell- 
fish, Welsh  rabbits,  and  the  like),  overeating,  or 
not  eating  enough,  foster  the  catarrhal  habit, 
either  directly  by  the  eructation  of  gases,  or  by 
the  absorption  into  the  blood  of  poisonous  proteids 
in  unsuitable  or  undigested  food.  How  often  has  a 
too  generous  meal,  washed  down  by  fiery  and  more 
generous  potations,  been  the  forerunner  of  a  cold! 

99 


WHY  DIE  SO  YOUNG? 

Bad  teeth  and  carelessness  regarding  the  toilet 
of  the  mouth  are  large  factors  in  the  development 
of  the  common  cold,  by  reason  of  the  germs  in- 
habiting the  buccal  cavity. 

Many  of  the  bacteria  mentioned  as  the  basis  of 
the  common  cold  are  found  also  in  the  mucous 
membranes  of  the  upper  air  passages  in  health 
and  between  attacks;  this  explains  reinfections, 
which  occur  when  predisposition  diminishes  bodily 
resistance  to  germinal  activity. 

Colds  are  caught  from  other  persons  having  colds, 
just  as  diphtheria  is  contracted  from  diphtheria 
sufferers;  and  common  colds  are  quite  as  likely  to 
come  in  epidemics,  affecting  whole  households, 
schools,  factories,  communities.  From  one  case 
alone  practically  the  whole  force  of  an  office  or  a 
workshop  may  presently  be  suffering,  even  acutely. 
The  employee  who  reports  for  work  sneezing, 
sniveling,  and  with  thickness  of  speech  had  far 
better  be  sent  home  until  he  has  recovered,  no 
matter  at  what  sacrifice.  It  will  be  found  to  pay 
in  the  end. 

The  common  cold  is  most  catching  in  its  early 

manifestations,    when    the    germ    laden    discharge 

from  the  nose  and  throat  is  sneezed  and  coughed 

and  spat  out  in  profusion.     Such  sufferers  should 

isolate  themselves  as  far  as  possible  and  should  go 

to  bed  the  first  three  days,  or  at  least  while  there 

is  fever.     The  contagiousness  and  the  severity  of 

colds  vary  greatly  in  different  epidemics,  according 

to  the  particular  germ  most  in  evidence  or  the 

nature  of  the  mixed  infections  when  these  exist. 

The  prevention  of  colds  consists  in  avoiding  the 

infection    and    in    fortifying    oneself    against    the 

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predisposing  factors.  During  epidemics  contact 
with  the  sufferers  should  be  avoided,  especially  in 
street  cars,  offices,  and  all  badly  ventilated  places — 
wherever  one  must  risk  having  one's  face  coughed 
or  sneezed  into  (droplet  infection).  The  germ  is 
also  transmitted,  directly  or  indirectly,  through 
inappreciation  of  hygienic  and  sanitary  usage, 
as  by  kissing,  the  common  drinking  cup,  the 
roller  towel,1  pipes,  toys,  pencils,  fingers,  food,  and 
other  means  of  contamination  through  the  fresh 
secretions.  Besides  avoiding  all  those  sources  of 
infection,  one  must  not  overwork  nor  lose  sleep 
during  epidemics. 

As  to  draughts:  the  robust  need  not  fear  them. 
The  very  young,  the  aged,  the  coddled,  and  the 
weak  had  best  avoid  them.  Yet  the  draught  does 
not  produce  the  infectious  cold.  We  speak  of 
colds,  and  I  have  here  used  the  term,  because 
the  first  symptom  of  the  infection  thus  named  is  a 
chill;  but  the  initial  chill  characterizes  many 
fevers — pneumonia  and  the  like.  The  chill  is  the 
effect  and  not  the  cause  of  the  infection,  which 
has  for  several  days  before  been  latent,  incubating 
in  the  system.  Most  such  chills  are  accompanied 
by  fever,  as  the  clinical  thermometer  demonstrates; 
the  suffering  is  therefore  rather  from  heat  than  from 
cold.  The  "cold"  is  caught  before  and  not  with 
the  appearance  of  the  chill. 

Cold  baths,  by  which  the  skin  is  helped  in  its 
function  of  throwing  off  daily  its  two  pounds  of 
bodily  waste;   exercise,  to  which  the  cold  air  gives 


1  Mark  Twain  wrote  of  a  hotel  in  which  he  objected  to  the  manager 
regarding  a  roller  towel:  "You  are  the  fiftieth  man  who  has  used 
that  towel,"  answered  the  manager,  "and  the  first  to  kick  about  it." 

8  101 


WHY  DIE  SO  YOUNG? 

zest;  sunshine;  wholesome  food,  by  which  the 
body  is  properly  nourished — one  should  accustom 
oneself  to  all  these.  He  who  does  will  have  his 
metabolism  (his  bodily  chemistry)  stimulated, 
his  blood  enriched,  not  only  his  voluntary  muscles, 
but  also  his  heart  musculature  strengthened,  and 
will  keep  his  nervous  system  in  healthy,  vigorous 
condition.  Such  a  one  is  practically  immune  to 
the  common  cold. 

INFLUENZA 

Influenza,  or  grippe,  is  an  epidemic  disease  which 
extends  with  extraordinary  rapidity.  It  is  likely 
to  "get"  some  40  per  cent  of  the  population 
it  visits,  and  to  be  epidemic  from  six  to  eight  weeks. 
Its  specific  germ,  without  which,  of  course,  its 
existence  were  impossible,  is  the  Bacillus  influenzae. 
"Cold  in  the  head"  (coryza);  pains  all  over,  "in 
the  bones";  chills  and  fevers;  suffering,  oftentimes 
severe  enough  to  prostrate — are  the  distinctive 
features.  In  the  respiratory,  the  most  common, 
form  of  the  grippe,  the  eyes  are  watery  and  in- 
flamed; the  handkerchief  is — or  ought  to  be — in 
constant  requisition  to  keep  the  germ  from  others 
as  it  is  sneezed,  coughed,  or  spit  out.  Sore  throat, 
bronchitis,  pain  in  the  chest,  and  profuse  perspira- 
tion are  in  evidence.  Or  the  digestive  apparatus 
may  suffer  most;  nausea,  vomiting,  collapse,  colic, 
jaundice  perhaps,  debility  invariably.  Or  the 
nervous  symptoms  may  be  most  manifest:  intense 
headache  and  backache,  pain  in  the  eyes,  a  racing 
pulse,  inflammation  of  particular  nerves  or  a 
group  of  nerves,  depressed  spirits,  and  a  profound 
prostration.     The  suffering  may  be  so  great  that 

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the  diagnosis  of  meningitis  may  be  made.  Or 
there  will  be  the  fourth,  the  peculiarly  febrile  form, 
in  which  the  temperature  may  go  up  to  the 
dangerous  height  of  105  degrees;  this  febrile  form 
has  to  be  differentiated  from  typhoid  fever. 
Complications  of  grippe,  heart,  and  kidney  disease, 
middle-ear  disease,  and  mastoid  abscess  have  to 
be  feared;  also  pleurisy  and  pneumonia  and,  in 
young  children,  bronchial  pneumonia. 

Too  often,  also,  grippe  leaves  in  its  train  chronic 
ill  health,  a  wabbly  heart,  and  a  pathetic  listless- 
ness  in  erstwhile  strong  and  virile  men;  and  many 
a  case  of  latent  tuberculosis  has  thus  become  no 
longer  dormant. 

Influenza  does  not  defer  to  climate,  wind,  or 
weather.  Cases  are,  however,  more  frequent  in 
the  winter  months.  There  have  been  in  the 
past  great  pandemics  of  grippe,  since  the  sixteenth 
century  at  least;  that,  for  example,  of  1889-90,  which 
spread  from  east  to  west,  over  all  civilization, 
with  very  considerable  mortality  and  a  grievous 
aftermath  of  chronic  malaise  and  suffering  in 
those  who  survived  the  attack.  Indeed,  it  was 
the  fashion  long  after  to  date  various  ailments 
from  this  1890  visitation.  Such  mortality,  such 
morbid  sequelae,  are  not  likely,  however,  to 
attend  present-day  epidemics,  because  with  succes- 
sive experiences  of  any  infection  its  virulence 
and  destructiveness  are  likely  to  be  progressively 
modified.  Even  now,  however,  for  the  very 
young  and  the  very  old,  grippe  is  likely  to  prove 
serious. 

Nor  is  influenza  one  of  those  infections  which, 
like   smallpox   or   measles,   confers   complete   im- 

103 


WHY  DIE  SO  YOUNG? 

munity  with  its  initial  attack.  Any  kind  of  im- 
munity to  influenza  is  indeed  but  slight.  Second 
and  third  individual  attacks  are  common.  And 
the  carriers  of  the  influenza  germs  are  probably 
numerous;  like  typhoid  carriers,  they  may  not 
suffer  at  all  themselves,  but  they  may  be  walking 
germ  granaries,  conserving  the  infection  for  future 
epidemics  to  feed  upon.  By  reason  of  the  bread- 
winner's greater  exposure,  males  and  the  robust 
are  likely  to  be  most  susceptible.  Exhaustion 
predisposes  to  grippe,  for  it  makes  the  bodily 
tissue  a  congenial  soil  for  germ  implantation  and 
morbid  activity.  For  instance,  a  military  corps 
detailed  for  railroad  construction  had  been  in 
constant  general  good  health  until  the  men  had 
to  work  hard  for  two  days  in  the  rain;  more  than 
a  hundred  then  developed  sore  throat  and  bronchi- 
tis, and  of  these  thirty-seven  presented  typical 
influenza. 

Influenza  is  highly  contagious,  being  spread 
from  person  to  person  by  immediate  contact,  as  in 
kissing,  or  by  indirect  contact,  as  from  handker- 
chiefs, towels,  cups,  and  other  objects  contami- 
nated with  the  fresh  secretions.  The  germ  exists, 
especially  in  the  early  stages,  in  the  secretions  of 
the  nose,  throat,  and  lungs. 

Mass  meetings,  theaters,  closed  and  crowded 
cars,  and  public  buildings  should,  as  far  as  possible, 
be  avoided  during  these  epidemics.  Persons  with 
a  tendency  to  catarrh  should  avoid  undue  ex- 
posure. Keep  the  feet  warm  and  dry  and  the 
bodily  functions  normal.  Influenza  is  one  of  those 
diseases  the  control  of  which  rests  with  the  public 
and  not  with  the  doctors,  except  so  far  as  it  is 

104 


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their  province  to  prescribe,  to  instruct  the  laity, 
and  to  urge  communal  support  of  perfectly  definite 
and  reasonable  health  department  measures. 

BRONCHITIS 

One  becomes  susceptible  to,  predisposed  to, 
"cold  on  the  chest"  by  getting  the  feet  wet,  by 
exposure,  fatigue,  overwork,  by  previous  weakening 
diseases,  by  food  that  is  indigestible  or  scanty  or, 
on  the  other  hand,  excessive  for  the  bodily  needs. 
"Catching  cold,"  which  very  frequently  results  in 
bronchitis,  comes  also  from  living  in  overheated 
rooms,  especially  when  oxygen-consuming  gas  is 
constantly  in  use  in  offices  and  workrooms,  and 
in  places  where  the  poisonous  exhalations  of  many 
people  together  is  being  rebreathed  hour  by  hour 
and  day  by  day — where,  in  short,  there  is  bad 
ventilation.  Those  whose  occupations  keep  them 
outdoors  are  not  nearly  so  prone  to  bronchitis  as 
are  sedentary  workers.  In  most  cases  bronchitis 
is  infectious,  a  germ  disease;  the  germs  of  catarrh, 
of  pneumonia,  of  grippe  are  frequently  found  in 
the  spittle  coughed  out  by  bronchitis  sufferers.  It 
seems  that  bronchitis  is  rare  among  fisherfolk,  by 
reason  of  the  germ-free  sea  air.  Besides  being  a 
germ  disease,  bronchitis  comes  also  in  such  oc- 
cupations as  lead  to  the  breathing  in  of  chemical 
fumes  and  of  irritating  particles  of  steel,  stone 
dust,  cotton  fiber,  and  the  like.  Bronchitis  is  also 
a  natural  accompaniment  of  many  diseases — 
measles,  typhoid  fever,  malaria,  asthma,  whooping 
cough,  and  so  on.  The  trouble  usually  begins 
with  a  cold  in  the  nose,  which  works  down  through 

105 


WHY  DIE  SO  YOUNG? 

the  throat,  past  the  Adam's  apple,  then  along  the 
windpipe  and  so  to  the  mucous  membrane  of  the 
bronchial  tubes,  which  thus  become  inflamed. 


PNEUMONIA 

For  generations  doctors  sensed  that  pneumonia 
is  "catching" — that  is,  a  germ  disease — because 
they  found  it  present  regularly  in  certain  houses, 
in  soldiers'  barracks,  in  jails,  and  in  schools;  they 
easily  traced  direct  infection  in  hospital  wards; 
and  they  recognized  epidemics  of  pneumonia,  as  of 
measles  and  scarlet  fever. 

But  not  until  recent  years  was  the  germ  of 
pneumonia  (the  "pneumococeus")  discovered.  In 
this  as  in  all  germ  diseases  two  kinds  of  causes 
have  to  be  taken  into  account:  first  the  presence 
of  the  germ  which  is  peculiar  to  the  disease  and  is 
its  specific  cause;  and  then  the  predisposition, 
which  weakens  the  body  and  makes  it  the  right 
kind  of  soil  for  the  germ  to  thrive  in. 

You  will  understand  this  better  by  taking  the 
example  of  a  family  of  half  a  dozen  people.  One 
or  two  of  them  will  come  down  with  pneumonia, 
while  the  others  will  escape.  But  why  do  they  not 
all  suffer,  since  in  the  family  relation  they  must  all 
have  been  about  equally  subject  to  the  germinal 
attack? 

The  reason  is  that  the  bodies  of  those  who  have 
come  down  were  predisposed — their  resisting  power 
to  the  germ  of  the  disease  was  diminished.  But 
in  the  bodies  of  those  who  escaped  the  organs  were 
sufficiently  healthy  to  triumph  over  the  infection; 
and  those  fortunate  members  of  the  family  had 

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in  their  blood  agencies  fighting  the  pneumococci, 
rendering  them  harmless,  and  even  consuming  and 
destroying  them. 

Predispositions  loom  up  very  large  indeed  in  the 
doctor's  practice;  it  is  a  great  deal  of  his  duty  to 
find  them  out  and  rectify  them,  if  this  is  possible 
to  be  done.  The  sad  thing,  however,  is  that  in  the 
dreadful  stress  of  modern  life  it  is  impossible  always 
to  avoid  them.  What  are  some  of  them,  with 
especial  reference  to  pneumonia? 

Men  have  a  greater  tendency  to  pneumonia 
than  women  because  of  the  greater  hardships  the 
family  breadwinner  has  to  endure.  In  the  change- 
able and  unsettled  months,  such  as  December  and 
March,  there  is  much  pneumonia;  such  months 
are  windy  and  dusty,  too,  and  that  has  a  great 
deal  to  do  with  the  spread  of  the  pneumonia  germs. 
Cold  and  wet,  especially  as  to  the  feet,  predispose 
by  lowering  the  bodily  resistance.  Then  of  a 
cold  day  a  man  will  go  into  a  stuffy  place  to  get 
himself  a  hot  whisky  punch,  and  will  go  right  out 
into  the  cold  again.  This  will  make  him  perspire 
and  have  the  effect  to  open  the  pores  of  his  skin 
to  the  cold;  so  comes  the  deadly  chill  that  starts 
the  attack  of  pneumonia. 

But  cold  itself  is  not  responsible  for  pneumonia; 
during  the  continuous  cold  of  January  and 
February  there  is  not  so  much  of  this  disease  as 
in  changeable  December  and  March.  Arctic 
explorers  never  have  pneumonia — anyway,  not  in 
the  Arctic,  because  the  germ  does  not  exist  in  that 
pure  air;  but  when  they  get  back  to  civilization, 
where  the  germ  abounds,  they  are  just  as  likely 
as  anybody  to  succumb. 

107 


WHY  DIE  SO  YOUNG? 

Fatigue  very  decidedly  predisposes  the  body  to 
pneumonia;  men  who  must  work  hard  through 
long  hours  and  in  inclement  weather  are  very 
apt  to  come  down  with  it.  Unhealthy  conditions 
of  the  upper  air  passages — catarrhs — tend  to 
"lung  fever."  There  are  chronic  diseases  of  the 
heart,  the  liver,  the  kidney,  and  the  stomach  to 
which  pneumonia  is  a  "terminal  infection" — that 
is,  one  dies  of  pneumonia,  to  which  those  other 
diseases  have  predisposed. 

An  injury  to  the  chest  wall  may  predispose. 
Alcoholism  is  at  fault  in  a  sad  number  of  cases; 
and  an  alcoholic  pneumonia  is  well-nigh  hopeless. 
There  is  more  pneumonia  in  the  cities  than  in 
the  country,  for  obvious  reasons,  but  especially 
because  the  germ  has  a  better  chance  to  thrive 
in  insanitary  conditions;  besides,  city  people  are 
more  irregular  in  their  living  and  they  are  over- 
crowded in  ill-ventilated  tenements. 

As  to  the  prevention  of  pneumonia.  In  the 
first  place,  the  predisposition  to  this  disease  has 
to  be  removed — an  easy  saying  this,  a  hard  one  to 
put  in  practice.  For  in  this  workaday  world  the 
struggle  for  existence  is  so  intense  that  it  is  im- 
possible to  remove  all  the  agencies  that  weaken 
the  body  and  lay  it  open  to  germinal  attack.  As 
for  the  germ  of  pneumonia,  the  pneumococcus,  we 
must  act  pretty  much  as  we  should  against  the 
germ  of  consumption,  as  we  shall  see.  The  sputum 
is  disinfected;  those  who  nurse  pneumonia  patients 
must  keep  their  mouths  and  throats  very  clean  by 
means  of  dentifrices  and  gargles;  they  must 
wash  their  hands  very  often  and  then  lave  them  in 
disinfecting  solutions.    After  the  patient's  recovery 

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or  removal  his  house  is  thoroughly  cleansed,  aired, 
and  opened  up  to  the  sunshine.  Those  who  need 
not  be  with  pneumonia  patients  had  best  not 
visit  them;  though,  of  course,  there  is  no  occasion 
for  the  fright  that  is  often  evinced,  as  if  such 
sufferers  had  the  plague.  However,  people  worn  out 
or  otherwise  susceptible  to  infection  should  not 
unnecessarily  expose  themselves  in  these  premises. 

A    CASE    OF    TUBERCULOSIS 

I  have  intimated,  in  these  pages,  how,  with 
adolescence,  begins  the  dreadful  consumption 
mortality  of  every  fourth  or  more  among  us. 
Here  is  one  of  the  most  melancholy  facts  in  all 
medical  experience.  I  do  not  know  how  more 
forcibly  to  present  the  matter  than  by  the  narration 
of  a  "case  history,"  the  like  of  which  comes  almost 
daily  under  the  observation  of  every  family  doctor. 

A  young  working  girl  had  caught  cold,  beginning 
in  the  familiar  way;  sneezing,  the  nose  stopped 
up;  headache;  at  first  dryness  in  the  throat,  then 
difficulty  in  swallowing  and  in  speaking;  cough; 
chills  and  feverish  sensations;  pains  in  the  chest 
(where  presently  the  cold  settled),  and  in  the 
bones  and  joints  (from  the  infection — the  toxemia — 
in  the  blood). 

Now  this  poor  girl  paid  little  attention  to  these 
symptoms;  she  considered  that  she  could  not 
afford  to,  because  she  had  to  work  for  her  living. 
She  would  not,  or  she  could  not,  in  the  cruel 
economic  conditions  which  bound  her,  stay  at  home 
and  nurse  her  cold  until  her  health  could  be  fully 
restored.     She  neglected  this  really  serious  condi- 

109 


WHY  DIE  SO  YOUNG? 

tion  until  her  deplorable  illness  took  on  a  tragic 
phase. 

Instead  of  resting  at  home  she  kept  on  working 
in  a  shop  where  she  was  employed,  next  another 
girl  who  had  consumption.  Now  this  other 
girl,  a  very  conscientious  girl,  of  course,  but  who 
was  ignorant  or  untrained  in  the  prophylaxis  of 
consumption,  coughed  into  the  air  about  her 
working  place  and  was  careless  as  to  the  disposi- 
tion of  her  sputum.  The  germ  of  her  disease  (the 
bacillus  of  tuberculosis)  became  thus  disseminated, 
so  that  any  predisposed  person  working  near  by 
her,  day  after  day,  would  certainly  become  subject 
to  the  tuberculous  infection.  And  this  pitiable 
result  is  precisely  what  came  to  pass.  The  poor 
young  woman  first  referred  to  had  become  run 
down,  predisposed,  by  reason  of  her  neglected 
cold;  and  her  tissues  now  provided  an  ideal  soil 
for  the  implantation  of  the  tubercle  bacilli. 

So  then,  her  lassitude  and  her  weakness,  her 
"tired  feeling"  increased  day  by  day,  she  felt 
none  of  her  former  eagerness  for  work,  she  had 
none  of  her  former  ability  to  concentrate  her  ener- 
gies upon  her  task,  for  in  truth  she  had  but  little 
energy  left  in  reserve;  she  was  easily  becoming 
exhausted;  her  appetite  was  poor;  she  was  losing 
flesh;  she  was  becoming  pale  except  for  an  un- 
wonted pink  flush;  she  felt  her  heart  beat  rapidly 
and  that  she  was  beginning  to  breathe  with  dif- 
ficulty on  exertion.  Chills  became  very  marked, 
also  fever;  she  perspired  all  too  easily,  especially 
at  night;  she  was  becoming  hoarse;  her  cough, 
which  she  with  pathetic  optimism  called  a  stomach 
cough  and  attributed  to  indigestion,  was  becoming 

no 


YOUTH 

so  persistent  that  she  got  no  relief,  despite  the 
sirups  and  the  patent  medicines  she  was  using, 
and  which  were  worse  than  useless,  because  they 
were  "turning  her  stomach." 

Finally,  she  found  a  streak  of  blood  in  her 
sputum;  and  then,  in  a  dreadful  fright,  she  did 
what  she  should,  of  course,  have  done  months 
before — she  went  to  her  doctor,  who  had  then,  all 
too  late,  to  tell  her  the  truth — that  she  had 
consumption. 

Now  this  girl  was  one  of  a  family  of  six.  She 
died  of  her  disease.  Her  father  was  addicted  to 
alcohol;  John  Barleycorn  and  the  Captain  of  the 
Men  of  Death  are  a  team  there  is  little  use  in 
resisting;  the  alcohol  easily  predisposed  him  to 
the  consumption  which  he  contracted  from  his 
daughter.  And  so  he  too  died.  The  mother  also 
came  down  with  tuberculosis,  and  succumbed  as 
did  her  daughter  and  her  husband;  and  a  strong 
son  of  eighteen  soon  suffered  the  same  fate — 
death  from  consumption.  And  so  on  until  all 
that  was  left  of  that  family  was  a  little  boy  of  six 
years,  who  had  a  tuberculous,  a  cold  abscess 
formation,  a  white  swelling  of  the  knee  joint, 
from  which  he  fortunately  recovered.  Such  is 
the  history  which  began  with  "nothing  but  a 
cold."  Nearly  every  day  the  practicing  physician 
comes  upon  like  neglected  cases. 

I  will  recapitulate  here,  by  reason  of  the  vast 

importance    of    the    subject,    the    early    signs    of 

tuberculosis.      1.  A    cough    lasting   more    than    a 

month    (except    whooping    cough,    in    which    the 

cough  lasts  six  weeks  or  more).     Such  a  cough 

may   not,   of   course,  mean   consumption,  but   it 

ill 


WHY  DIE  SO  YOUNG? 

certainly  calls  for  a  thorough  medical  exami- 
nation. 2.  Hoarseness  lasting  several  weeks.  3. 
Poor  appetite  (especially  in  the  morning),  indi- 
gestion, loss  of  weight  and  strength,  paleness,  and 
a  generally  run  down  condition  ("that  tired 
feeling").  4.  Hawking  and  spitting,  especially  in 
the  morning.  5.  Night  sweats.  6.  A  streak  of 
blood  in  the  sputum.  7.  Afternoon  fever,  shown 
by  flushed  face  and  alternating  with  chilly  sensa- 
tions. The  spittle  has  to  be  examined  for  the 
tubercle  bacillus,  the  consumption  germ.  But  it 
must  not  be  concluded  that  there  is  no  tuberculosis 
if  this  germ  is  not  found,  even  after  several  exami- 
nations. The  test  is  absolute  if  it  is  positive;  not 
so  if  it  is  found  negative.  Many  doubtful  cases  will 
be  cleared  up  by  X-ray  examination  of  the  chest. 

THE  PHYSIOLOGICAL   PRINCIPLES 

Following  are  the  modern  principles  of  con- 
sumption treatment,  by  which  most  early  cases 
can  be  cured,  many  even  advanced  cases  arrested 
in  their  development;  and  by  which  comfort  and 
relief  can  always  be  assured.  These  principles 
can  be  pointed  off  on  the  thumb  and  fingers  of  one 
hand. 

First,  there  must  be  careful  disposal  of  the 
sputum  of  the  consumptive — practically  the  only 
means  by  which  the  disease  is  conveyed  from  one 
person  to  another.  The  handkerchief  or  a  cloth 
must  be  always  held  before  the  patient's  face 
when  he  coughs,  sneezes,  or  spits  out;  thus  is 
droplet,  or  spraying,  or  atomizing  infection  avoided. 
The    patient's    handkerchiefs,    towels,    linen,    bed 

112 


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sheets,  and  the  like  must  be  boiled  by  themselves 
before  being  added  to  the  general  wash.  What- 
ever can  be  must  be  burned.  The  spittoon  must 
contain  some  fluid  (water  will  suffice)  in  order  that 
the  sputum  may  not  dry  and  become  incorporated 
with  the  dust.  And  the  spittoon,  when  cleaned, 
must  be  scalded;  this  will  kill  the  tubercle  bacilli, 
the  consumption  germs. 

Secondly,  there  must  be  rest.  There  is  otherwise 
no  hope  for  the  consumptive's  emaciated  body, 
an  organism  ever  on  the  verge  of  bankruptcy. 
Here  is,  of  course,  a  factor  difficult  of  management, 
especially  among  the  poor  (who  furnish  the  ma- 
jority of  the  consumption  cases),  many  of  whom 
feel  that  they  must  somehow  work  in  order  to 
maintain  themselves  and  their  own.  Nor  what, 
indeed,  can  be  more  pathetic  than  that  the  con- 
sumptive is,  more  likely  than  not,  the  family 
breadwinner?  And  yet  there  has  to  be  rest,  es- 
pecially when  there  is  fever,  and  at  least  until 
the  sufferer  has  recuperated  from  the  exhaustion 
which  has  been  the  prime  predisposition  to  the 
disease.  For  the  consumptive  germ  battens  on 
devitalized  tissues. 

The  rest  has  got  to  be  absolute  if  the  bodily 
temperature  reaches  100  degrees  by  the  clinical 
thermometer;  and  the  bed  inexorably  when  the 
fever  has  gone  above  this.  The  rest  should  be,  if 
possible,  out  of  doors — at  least  with  open  windows. 
When  the  air  is  cold  warm  headgear  is  to  be  worn; 
or  the  woolen  "helmet"  which  comes  down  over 
the  collar  bone.  And  the  footwear  must  be  at 
least  as  ample  and  as  comfortable  as  the  headgear. 
The  body  must  be  abundantly  clothed;   there  are 

113 


WHY  DIE  SO  YOUNG? 

sleeping  bags  made  for  such  patients.  The  idea 
of  sleep  is  involved  in  that  of  rest.  Nowhere  else 
should  nature's  soft  nurse  be  so  sedulously  wooed. 
Insomnia  is  most  exhausting  in  such  a  disease  as 
this,  when  it  is  so  necessary  to  build  up  and  con- 
serve the  strength.  Nor  has  any  restorative  even 
been  invented  to  compare  with  sleep.  Insomnia 
with  fatigue  and  overexertion  have  predisposed  to 
many  a  case  of  tuberculosis.  We  strive  for  sleep 
without  medication  if  possible;  it  may,  among 
other  ways,  be  induced  by  the  drinking  of  hot 
milk  after  the  patient  has  been  tucked  away  for 
the  night. 

The  third  principle  underlies  what  is  called  the 
"twenty-four  hour  cure."  It  is  that  the  patient 
should  every  possible  moment,  day  and  night, 
twenty-three  hours,  anyway,  breathe  fresh  air  and 
be  in  the  sunshine  so  long  as  there  is  a  ray  of  it. 
(Of  course,  the  excessive  heat  of  the  summer  sun 
must  be  avoided.)  At  night,  no  matter  how  cold, 
the  windows  are  to  be  open;  nailed  up,  not  down, 
if  there  has  to  be  any  nailing  to  be  done.  The 
colder  the  air,  the  surer  the  cure;  more  patients 
recover  in  the  winter  than  in  the  summer.  Draughts 
are,  however,  to  be  avoided.  This  can  be  done  by 
means  of  a  screen  or  a  blanket-decked  clotheshorse 
appropriately  placed.  Only  twice,  from  day  to 
day,  should  the  windows  be  closed.  A  member  of 
the  family  comes  in  half  an  hour  before  dressing 
time  and  shuts  the  windows;  and  at  bedtime  the 
patient  undresses  with  closed  windows.  Then 
when  he  is  snugly  in  bed  for  the  night,  some  one 
opens  his  windows  for  him. 

The  fourth  principle  calls  for  plenty  of  nutritious 

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foodstuffs,  coupled  with  good  digestion,  so  that  all 
the  fuel  taken  into  the  body  may  be  converted 
into  healthy,  germ-resisting  tissues.  The  doctor 
must  decide  details  for  individual  cases;  but,  in 
general  terms,  we  try  for  the  largest  amount  of 
nourishment  with  the  least  amount  of  labor  for 
the  digestive  tract.  Thus  the  patient  should  eat 
roasted  or  broiled  meats  (beef,  mutton,  or  lamb), 
fowl,  fresh  vegetables,  and  fruits,  cereals  liberally 
mixed  with  cream,  plenty  of  sugar,  good  butter, 
a  generous  admixture  of  table  salt  and,  at  or 
between  meals  (if  the  appetite  will  stand  for  it), 
from  six  to  eight  eggs,  and  from  one  to  three 
quarts  of  milk  daily.  Such  indigestibles  as  in- 
nutritious  sweets,  pastries,  and  dainties,  must  be 
avoided;  these  interfere  with  normal  metabolism 
(the  perfect  conversion  of  oxygen,  fluid,  and  food 
into  healthy  organs  and  tissues).  Between  meals, 
at  any  rate,  plenty  of  water  should  be  drunk, 
for  no  food  is  absorbed  that  is  not  ultimately  in 
fluid  form.  No  alcohol,  except  by  the  doctor's 
prescription. 

Finally  comes  the  fifth  principle.  No  patient 
shall  use  medicine  without  the  direction  of  his 
doctor.  Patent  medicines  (which  have  an  alcohol 
content  sometimes  as  large  as  whisky)  must  be 
avoided.    Avoid  the  nauseating  sirups. 

These  physiological  principles,  under  the  physi- 
cian's direction,  are  applicable  to  many  other  dis- 
eased states. 

THE  CONSUMPTIVE  PATIENT 

Upon  being  told  of  his  malady  the  patient  is 
likely  to  become  dreadfully  affected;   will  look  the 

115 


WHY  DIE  SO  YOUNG? 

doctor  anxiously  in  the  face.  But  the  latter  has 
composed  his  features  to  clear-eyed,  calm,  and 
gmtle  sympathy;  and  his  voice  is  both  firm  and 
kindly  while  he  is  meeting  the  patient's  quivering 
lips,  his  white,  tense,  dilated  nostrils,  and  his  swim- 
ming eyes,  over  which  he  presently  puts  his 
trembling  fingers. 

Following  on  this  initial  shock,  however,  the 
patient's  psychology  is  pretty  much  that  of  the 
soldier.  When  the  prospect  of  going  into  battle 
first  confronts  the  recruit,  he  will  have  a  sense  of 
terror,  no  matter  how  well  established  his  courage ; 
but  his  emotion  is  certain  presently  to  give  way 
to  that  of  exultation  and  to  a  belief  that  the  fight 
which  has  to  be  made  will  ultimately  be  a  victorious 
one. 

The  patient  must  be  obedient  to  his  physician, 
and  persistent  in  every  detail  of  the  treatment 
enjoined  upon  him.  He  will  be  for  the  most  part 
confident  of  his  recovery — a  state  of  mind  (the 
spes  phtkisicorum)  happily  prevalent  among  con- 
sumptives. He  must  understand  that  his  im- 
provement and  final  recovery  will  depend  largely 
on  his  own  conduct.  He  must  consider,  before  he 
undertakes  any  business  or  other  matter,  how  his 
chance  of  getting  well  will  be  affected  thereby. 
He  must  make  it  a  habit  to  converse  with  no  one 
except  his  physician  or  his  nurse  about  his  disease. 
He  must  absolutely  not  adopt  the  prescriptions  of 
solicitous  friends.  However  well  he  may  imagine 
himself,  he  must  continue  under  this  doctor's 
care  until  he  has  been  dismissed.  As  we  have 
considered,  there  is  no  routine  medicine,  no  set 
prescription  for  the  cure  of  consumption.     And 

116 


YOUTH 

medicines  are  now  held  subsidiary  to  hygienic 
measures.  The  doctor  individualizes  in  treating  the 
consumptive,  as  he  must,  indeed,  for  all  patients 
of  whatever  disease.  The  various  organic  functions 
have  to  be  regulated,  according  to  the  peculiar 
conditions  and  necessity  and  the  complex  relations 
of  the  organs  and  tissues. 

THE   CONSUMPTIVE'S   DOCTOR 

The  consumptive's  doctor  will  take  every  possible 
means  to  recognize  the  disease  in  its  early  stages :  for 
every  week's,  indeed,  every  day's,  delay  in  establish- 
ing the  treatment  jeopardizes  progressively  the  pa- 
tient's chances  of  regaining  health.  The  generalship, 
the  recognition  of  many  elements  to  be  considered, 
the  material  at  hand  with  which  the  disease  may  be 
fought — such  are  within  the  doctor's  province. 
The  sufferer  must  be  made  to  rest  confidently 
upon  his  strength,  his  judgment,  and  his  latent 
resourcefulness.  The  consultations  must  unvary- 
ingly and  unfailingly  be  an  inspiration.  There  has 
got  to  be  something  of  a  subconscious  bond  or 
compact,  in  which  earnest  solicitude  will  be  the 
doctor's  contribution,  and  loyal  obedience  that  of 
the  patient.  The  latter  is  physically  weak  and 
lacking  in  nerve  energy;  his  psychic,  his  mental 
stamina,  is  like  to  be  correspondingly  below  par. 
He  will  consequently  need  constant  suggestioning 
of  health  and  vigor,  not  only  when  he  realizes  that 
he  needs  these  things,  but  even  more  so  when  he 
imagines  that  he  does  not — like  so  many  who 
need  to  pray,  not  so  much  when  they  are  un- 
fortunate as  when  they  are  becoming  prosperous. 

9  117 


WHY  DIE  SO  YOUNG? 

For  it  is  in  the  latter  season  that  the  "bad  breaks" 
are  made.  The  doctor  will  study  the  patient's 
mental  condition;  he  will  recognize  that  in  many 
consumptives,  especially  women,  the  emotions  and 
the  will  are  apt  to  be  unstable.  He  will  deal  severely 
with  the  frivolous  (strange,  outre,  indeed,  how 
many  consumptives  are  that  way);  he  will  en- 
courage the  despondent;  he  will  with  redundant 
patience  instruct  the  ignorant.  His  directions 
must  be  clear  and  definite;  concerning  them  the 
patient  must  never  be  left  in  doubt.  He  has  to 
explain  the  nature  of  the  disease,  not  only  to  the 
patient's  family,  but  also  to  the  patient  himself. 
It  is  very  wrong  to  speak  mildly  of  a  pulmonary 
catarrh,  of  a  little  trouble  at  the  top  of  the  lung, 
to  soothe  the  patient's  feelings  (with  a  kind  of  sugar- 
of-lead  sweetness)  with  the  result — how  often  has 
this  been  so! — that  the  latter  may,  through  not 
understanding  the  gravity  of  the  situation,  be 
negligent,  with  fatal  outcome.  There  are  physicians 
of  whom  consumptives  have  said,  in  dying,  "If 
my  doctor  had  but  told  me  the  truth  I  might  have 
been  well  to-day."  For  an  evasive  diagnosis  no 
consumptive  will  observe  the  rigid  regimen  essential 
to  recovery,  nor  will  such  a  one  renounce  his 
favorite  habits  and  pleasures;  nor  his  vocation, 
if  need  be;  nor  the  time  and  money  to  achieve  his 
cure;  nor  will  he  leave  his  own  people  and  his 
familiars. 

BATHING 

No  one  can  be  really  healthy  who  does  not 
consider  carefully  the  emunctories,  the  eliminative 
organs,  among  which  we  now  consider  the  skin. 

118 


YOUTH 

Science  has  proved  that  the  varnished  frog 
croaks  its  last  croak  when  the  air  it  breathes 
becomes  warmer  than  96  degrees — which  is  hot 
for  frogs,  but  which  the  unvarnished  frog  will 
survive.  The  frog  must  use  the  pores  of  its  skin 
to  radiate  the  extra  heat,  which  it  cannot  do  when 
it  is  varnish-coated.  Moreover,  disease  germs  make 
short  work  of  varnished  frogs  that  are  already 
weakened  through  sweltering.  There  are  humans 
who,  although  they  are  not  varnished,  yet  take  on 
coats  of  other  material  quite  as  deleterious  to 
health;  as  in  the  case  of  the  individual  who,  in 
overweening  pride,  boasted  of  his  bathing  regularly 
every  Fourth  of  July,  whether  he  needed  it  or  not. 
Also,  improper,  too  long  unchanged,  and  too  much 
clothing  disturbs  the  functions  of  the  skin,  some- 
times seriously. 

The  skin  is  an  organ  of  respiration,  and  as 
such  is  a  part  of  the  body's  breathing  mechanism. 
And  the  skin  secretes,  as  when  its  sebaceous  oil 
glands  keep  it  from  becoming  dry;  and  it  excretes, 
as  in  perspiration.  He  who  bathes  o'  mornings 
gets  his  blood  elements  enriched,  and  avoids 
blood  stagnation — a  very  evil  thing;  has  his  lung 
power  and  area  increased;  his  appetite  and  nutri- 
tion enhanced,  and  the  food  elements  better 
stowed  away  in  those  parts  of  the  body  where 
they  belong;  is  assured  a  sense  of  mental  as  well 
as  physical  well-being;  and  in  cases  where  such 
improvement  is  desirable  has  his  morals  decidedly 
improved.  The  skin  is  the  peripheral — that  is, 
the  surface — heart.  As  we  noted  in  our  first  part, 
a  child  from  two  to  ten  years  old  has  a  skin  surface 
up  to  ten  square  feet;    and  underneath  this  is  a 

119 


WHY  DIE  SO  YOUNG? 

stream  of  blood  and  lymph  that  should  be  in 
constant  and  rapid  circulation.  If  such  circu- 
lation takes  longer,  or  if  there  are  pools,  eddies, 
and  pockets  by  the  way,  the  bodily  organs  and 
tissues  will  get  clogged  up  with  impure  blood,  and 
will  become  most  hospitable  to  all  kinds  of  disease 
germs.  The  whole  bodily  machinery  will  become 
clinkered  up,  and  sooner  or  later  that  body  will 
suffer  disease.  The  grown-up  who  has  several 
yards  of  peripheral  heart  and  a  veritable  sea  of 
blood  flowing  through  it  should  bathe  regularly. 
Let  him  not  be  as  the  varnished  frog. 

SKIN   CANCER 

A  word  here  to  young  women  about  birthmarks 
and  the  beauty  doctor.  Later  we  shall  discuss 
cancer.  This,  a  disease  usually  of  middle  and 
advanced  life,  is  now  come  upon,  in  the  form  of 
skin  cancer,  with  unprecedented  frequency,  in 
women  as  young  as  eighteen  years.  How  explain 
this  most  sad  state  of  things? 

Almost  all  cancers  are  the  result  of  "precancerous 
conditions"  in  the  body,  plus  irritation.  Among 
such  conditions  are  moles  and  certain  warts  from 
which,  when  they  are  irritated,  cancer  develops. 
Every  wise  grandmother  will  tell  you  that  moles 
and  birthmarks  that  are  giving  no  trouble  had 
far  better  not  be  meddled  with,  lest  malignant 
disease  result  from  disturbing  them. 

Time  was  when  women  considered  birthmarks 

to  be  beauty  spots;    if  they  did  not  have  these 

marks   by   natural    right,    they   put   black    court 

plaster  imitations  of  them  on  their  faces.    But  the 

fashion  is  now  changed,  and  many  foolish  women 

120 


YOUTH 

resort  to  beauty  parlors  for  the  removal  of  moles 
and  the  like,  oftentimes  by  utterly  inexperienced 
operators,  who  realize  nothing  of  the  danger 
lurking  in  their  proceedings.  They  will  remove 
what  they  can  see  of  a  mole  or  of  a  warty  growth 
or  other  so-called  blemish,  leaving  behind  a  micro- 
scopic portion;  and  thus  have  they  irritated  the 
tissues  at  the  site  of  their  imperfect  operation, 
have  incited  part  of  the  growth  not  visible  to  the 
naked  eye,  to  cancer  development. 

Most  certainly  moles  and  the  like,  which  have 
already  suffered  irritation — birthmarks  on  the  neck, 
for  instance,  that  have  been  rubbed  to  inflam- 
mation by  those  boned  collars  that  reach  to  the 
ears  and  above;  sores  that  will  not  readily  heal; 
or  any  warts  and  moles  that  show  swelling  and 
give  pain — all  such  must  indeed  be  attended  to. 
But  this  only  by  doctors  and  surgeons  of  tried 
skill,  experience,  and  reputation.  The  black  or 
red  mole  raised  from  the  face,  either  smooth  or 
rough,  and  perhaps  containing  hairs,  is  the 
most  dangerous  to  irritate  or  to  operate  on;  and 
many  a  fatal  cancer  has  resulted  from  tampering 
with  them.  In  any  event  what  do  you  get  from 
your  visit  to  the  beauty  doctor?  In  place  of  a 
comely  mole,  a  scar  looking  like  a  vaccination 
mark,  or  a  pitting,  or  a  parchment  like  a  blotch. 
Do  not,  therefore,  take  any  chances  with  a  natural 
growth  with  which  you  are  blessed  and  which  is 
resting  peacefully  in  the  skin. 

GREAT  ACHES  FROM  LITTLE  TOE  CORNS  GROW 

The    doctor    writing    this,    being    no    medical 

fledgling,    knows    better   than    to    try   instruction 

121 


WHY  DIE  SO  YOUNG? 

wherever  fashion  has  a  contrary  voice.  And  it 
does  not  matter  that,  like  most  men,  I  like  a 
comely  foot,  a  natural,  anatomic  foot,  such  as 
Grecian  women,  the  most  beautiful  in  the  world, 
had — an  ample,  generous  foot,  if  the  woman's 
architectural  proportions  called  for  it;  and  a 
small  foot,  so  long  as  it  was  symmetrical  and 
proportioned  to  the  small  woman.  But  in  Greece 
they  never  aimed  for  an  unnaturally  small  foot, 
a  monstrous  foot;  for  monstrosities  are  things  out 
of  proportion,  too  small  as  well  as  too  large. 

If  fashion  decrees  that  feet  shall  be  incased  in 
ugly  gear,  by  which  they  shall  ever  after  remain 
distorted,  which  shall,  besides,  give  constant  pain, 
which  shall,  by  making  difficult  walking  and  exer- 
cise in  the  open  air,  prevent  women  from  living  the 
physiological  life — why,  then,  fashion  is  going  to 
triumph  and  nothing  any  male  person,  doctor  or 
no  doctor,  can  say  is  going  to  avail. 

And  yet  there  have,  of  late  years,  been  rather 
successful  efforts  made  to  bring  Dame  Fashion, 
even  though  she  goes  to  extremities,  into  working 
relations  with  hygiene.  Many  of  the  great  shoe 
manufacturers  now  consult  surgeons  in  their 
shoe-construction  plans,  try  to  learn  a  little  some- 
thing about  the  anatomy  and  the  mechanics  of  the 
human  foot. 

The  most  common  fault  in  a  shoe  is  that  the 
instep  is  too  narrow,  and  the  point  of  the  shoe 
slopes  forward  equally  from  both  sides,  coming  to  a 
point  midway  between  the  two  margins  of  the 
heel  of  the  shoe.  A  natural  foot  undistorted  by 
fashion  or  misuse  has  the  great  toe  in  a  nearly 
straight  line  with  the  inner  border  of  the  foot,  so 

122 


YOUTH 

that  a  shoe  made  on  the  plan  mentioned  throws 
the  toes  together  in  a  bunch,  especially  if  those 
abominations,  French  heels,  have  been  built  in. 

Thus  results  the  unromantic  bunion  which, 
unlike  the  corn,  is  a  bony  displacement  outward 
and  an  ugly  one — where  the  first  bone  of  the  great 
toe  joins  the  rest  of  the  foot  on  the  inside.  And 
the  same  applies  to  the  outside  of  the  foot  if  the 
little  toe  is  misused  in  the  same  way. 

Then,  in  the  course  of  time,  friction  and  irrita- 
tion produce  a  thickening  and  hardening  of  the 
skin  over  the  bunion.  Then  the  great  toe  gets 
pushed  under  the  other  toes.  And  in  gouty  or 
rheumatic  people  the  bone  of  the  foot  joining  the 
big  toe  also  becomes  enlarged  and  twisted.  Thus 
is  the  natural  elasticity  of  the  foot  altered,  the 
movements  restricted,  and  much  intense  suffering 
caused — so  bad  that  surgery  may  have  to  be  done. 

The  best  way  to  avoid  all  this  malformation 
and  torture  is  to  start  life,  and  keep  up  throughout 
life,  using  a  shoe  with  a  straight  inner  edge. 
Shoes  are  also  made  with  divisions  between  the 
big,  and  the  other  toes.  Stockings  with  a  pocket 
for  each  toe,  the  same  as  gloves,  are  also  to 
be  had. 

The  toe  mark  of  civilization  is  the  corn,  which, 
indeed,  may  appear  in  any  part  of  the  skin  of  the 
foot  that  is  constantly  pressed  upon.  The  conse- 
quences are  sometimes  singularly  remote.  Even 
curvature  of  the  spine  has  resulted  from  the 
sufferer's  efforts  to  relieve  the  foot  in  walking. 
And  the  corn  may,  in  men,  interfere  with  exercise 
and  business,  and  be  productive  of  nervousness, 
dyspepsia,  insomnia,  and  profanity.     Indeed,  ab- 

123 


WHY  DIE  SO  YOUNG? 

scesses  and  gangrene  may  result  from  an  inflamed 
corn. 

Of  course,  the  way  to  avoid  such  troubles  is 
to  get  rid  of  the  pressure  which  has  caused  the 
corn,  by  wearing  the  right  kind  of  shoe.  Corns 
appear  even  on  babies'  feet.  Therefore,  the 
wearing  of  sensible  shoes  should  begin  with  the 
wearing  of  any  kind  of  shoes  at  all.  A  splendid 
rule  is  to  buy  shoes  you  can,  with  perfect  ease  and 
comfort,  walk  out  of  the  store  in,  and  buy  no 
other. 

There  are  several  other  troubles — ingrowing 
toenails,  flesh  growing  over  nails,  calluses  that 
may  become  as  thick  as  leather,  hammer  toes, 
and  so  on,  all  caused  in  most  cases  by  not  wear- 
ing the  right  footgear,  and,  if  permitted  to  grow 
worse,  resulting  in  malformation  and  ugliness  in 
what  ought  to  be  one  of  the  handsomest  parts  of 
the  body. 

EXERCISE 

The  right  development  of  the  muscular  system, 
along  with  good  food,  pure  air,  and  the  living  of 
the  hygienic  life  in  general,  is  essential  to  human 
efficiency  and  longevity.  A  muscle  unused  for 
any  period  diminishes  in  bulk  and  degenerates  in 
quality. 

I  recall  one  of  my  fellow  internes  in  hospital,  a 
man  at  that  time  of  magnificent  physique,  strength, 
and  stamina,  as  well  as  of  superior  intellect,  and, 
by  the  way,  an  expert  boxer.  Tradition  has  it 
that  he  actually,  while  on  a  holiday  at  Coney 
Island,  toppled  over  the  renowned  John  L.  Sullivan, 
for  a  rudeness  the  latter  had  offered  a  lady.    And 

124 


YOUTH 

it  is,  I  am  sure,  in  no  wise  a  detraction  from  my 
friend's  heroism  that  John  L.  had  previously 
had  any  number  of  rounds  with  John  Barleycorn 
and  was  consequently  not  up  to  his  fighting  form. 
In  a  moment  of  epic  indiscretion,  during  an  after- 
noon's relaxation  in  the  hospital,  I  "took  on  a  go" 
with  my  athletic  friend;  and  all  I  have  to  do  this 
day,  may  years  after,  is  to  close  my  eyes  and  I 
can  see  again  those  very  same  stars. 

Some  years  after  our  hospital  service  I  was 
astonished  and  pained  to  meet  my  friend  and  to 
find  him  gaunt  and  feeble.  He  had  had  typhoid, 
he  told  me,  and  for  months  after  recovery  from 
the  disease  itself  he  could  not  ride  a  bicycle  a 
block  without  having  to  desist,  exhausted,  winded, 
and  sweating  "like  one  in  a  tertian";  he  could 
not  concentrate  his  mind  through  to  the  bottom 
of  a  single  page  in  any  book. 

After  a  month  of  illness  and  at  the  beginning 
of  his  convalescence  he  wanted  to  get  out  of  bed. 
His  nurse  told  him  he  was  not  strong  enough  for 
that.  Vexed  and  hurt  by  such  an  assertion,  he 
did  get  up  and  at  once  fell  to  the  floor  in  a  heap; 
for  his  muscles,  unused  during  his  illness,  had 
become  flabby  and  the  legs  of  that  erstwhile 
Hercules  had  become  pathetically  spindle-shanked. 

Exercise,    to    be    salutary,    must    be   judicious. 

Taken  to  the  point  of  extreme  fatigue,  day  after 

day,  it  may  do  harm.    When  a  muscle  is  worked, 

some  of  its  substance  is  used  up.     At  the  same 

time  and  afterward  more  blood  flows  into  it,  and 

if   the   exercise   is   not   too   violent   and   the   rest 

intervals  are  long  enough  the  repair  and  growth 

will  keep  pace  with  or  exceed  the  wasting.     But 

125 


WHY  DIE  SO  YOUNG? 

excessive  work  and  too  short  rest,  like  too  little 
exercise,  will  tend  to  muscle  diminution  and 
enfeeblement. 

Few  persons  among  us  can  profitably  work 
hard  daily  with  both  brain  and  muscle;  but  we 
should  all  regularly  use  both,  choosing  which  to 
work  with  and  which  merely  to  exercise.  For 
persons  of  average  physique  whose  occupations  are 
sedentary — clerking  and  the  like — the  minimum  of 
daily  exercise  should  be  an  amount  equivalent  to  a 
five-mile  walk. 

Since  extra  muscle  work  means  extra  muscle 
waste,  and  should  be  accompanied  by  an  abundant 
supply  of  food  material  to  the  muscles,  violent 
exercise  should  not  be  taken  after  a  long  fast,  nor 
immediately  after  a  meal — for  much  blood  is  then 
needed  in  the  digestive  organs  to  provide  material 
for  metabojism.  Hearty  young  people  may  take 
a  long  walk  before  breakfast;  but  others  should 
wait  until  after  eating  before  engaging  in  any 
kind  of  exertion. 

WALKING 

I  am,  for  my  part,  very  strong  for  walking.  The 
exercise  has  many  most  notable  exemplars.  Samuel 
Johnson  tramped  through  the  Hebrides,  for  all 
his  scrofula.  Oliver  Goldsmith  (himself  a  physician, 
though,  it  is  to  be  feared,  an  indifferent  one)  was 
for  years  a  wayfarer  along  the  courses  of  the 
lazy  Scheld  and  wandering  Po,  and,  fiddle  under  his 
arm,  through  much  else  of  Europe.  Mark  Twain 
tramped  abroad — when  he  could  not  get  a  hitch 
or  take  a  boat.  Blaikie,  in  his  immortal  book, 
How  to  Get  Strong  and  How  to  Stay  So,  in  the  last 

126 


YOUTH 

of  many  editions  as  well  as  in  the  first,  maintained 
the  best  of  all  exercises  to  be  walking. 

"Give  me,"  enthused  Hazlitt,  "the  clear  sky 
over  my  head  and  the  green  turf  beneath  my 
feet,  a  winding  road  before  me,  and  a  three  hours' 
march;  and  then  to  thinking";  whereat  Stevenson, 
"And  he  must  have  a  winding  road,  the  epicure." 
Poor  Stevenson,  who  could  so  well  appreciate, 
but  latterly  had  to  give  up  this  blessed  recreation, 
by  reason  of  his  consumption!  In  other  and  more 
virile  generations  men  thought  nothing  of  a  thirty- 
mile  jaunt.  For  Dickens  it  would  have  been  just 
a  freshener — just  one  hearty  meal  of  divine  air, 
with  wondrous  landscapes  and  conversations  with 
his  rural  countrymen  on  the  side.  Lily  Langtry 
in  her  prime  frequently  did  her  twenty  miles  a 
day;  no  wonder  she  was  handsome. 

A  young  woman,  by  the  way,  recently  asked  her 
physician  to  prescribe  for  her  a  complexion  im- 
prover. Being  no  beauty  doctor,  he  did  what  he 
thought  the  best  for  her  and  advised:  "Get  one 
pot  of  rouge  (any  kind  of  rouge)  and  one  rabbit's 
foot  (not  necessarily  a  left  hind  foot).  Bury  them 
together  two  miles  from  home  (or  from  the  line 
of  any  trolley  or  other  means  of  conveyance),  and 
walk  out  and  back  (in  any  and  every  kind  of 
weather,  wearing,  if  necessary,  arctics  or  rubbers 
in  rain  or  snow) *  so  as  to  be  sure  those  articles  are 
still  where  you  have  buried  them.  Besides  this, 
go  to  bed  so  that  you  will  be  sure  to  sleep  eight 
hours;  lie  down,  if  possible,  half  an  hour  after 
lunch;    bathe  in  water  as  cold  as  possible  within 

1  There  is  no  bad  weather;   there  are  only  different  kinds  of  good 
weather.  — Ruskin. 

127 


WHY  DIE  SO  YOUNG? 

comfortable  limits,  giving  yourself  a  good  rub 
down  after  the  bath;  eat  three  square  meals  of 
wholesome  food  daily,  cutting  out  the  sweets  and 
the  indigestive  and  innutritive  pastry;  drink  six 
glasses  of  water,  at  least,  during  the  day;  see  that 
the  body's  emunctories  are  functioning  properly. 
And  I  guarantee  you  will  then  have  a  complexion 
that  will  stop  the  traffic  on  any  thoroughfare 
you  will  choose  to  grace  with  your  presence." 

Nor,  in  our  own  supine  day  of  the  enervating 
motor  car  and  the  all  too  ubiquitous  trolley,  is 
the  magnificent  art  of  walking  altogether  neglected. 
Has  not  Dr.  John  Finley,  formerly  president  of 
the  College  of  the  City  of  New  York,  now  Com- 
missioner of  Education  of  the  Empire  State,  and 
at  any  time  writer  of  fine  verse,  done  his  thirty 
miles  in  nine  hours,  in  the  nighttime  too,  when 
most  of  the  rest  of  us  were  sleeping,  beginning  with 
Elizabeth,  New  Jersey,  and  ending  up  at  Princeton 
for  breakfast!  Starting  at  In  wood  on  Manhattan 
Island,  walking  along  the  Hudson  front  to  the 
Battery,  and  thence  up  along  the  East  River  (most 
picturesque  of  urban  shores),  to  the  Harlem,  was 
just  one  stroll  for  that  plain  liver  and  great  thinker. 
And  my  friend,  Dr.  Richard  Cole  Newton,  who 
admits  threescore  and  perhaps  a  year  or  two 
more,  is  a  very  energetic  walker,  who  keeps  on 
throwing  off  such  little  stunts  as  a  ninety-mile 
jaunt  in  the  twenty-four  hours,  starting,  say,  from 
Newark,  New  Jersey,  making  stops  at  Elizabeth, 
New  Brunswick,  Princeton,  and  Trenton,  and 
ending  up  at  North  Philadelphia.  Superb  harkings 
back,  these,  to  the  very  efficient  footwork  times 
when  the  news  of  Marathon  was  brought  to  Athens, 

128 


YOUTH 

when  Caesar's  legions  traversed  Gaul,  and  Hannibal 
•crossed  the  Alps  and  Lucknow  was  relieved! 

Those  not  accustomed  to  long  walks  and  who 
want  to  get  the  fine  habit  should  take  some  pre- 
cautions. The  strength  must  not  be  overtaxed 
in  the  beginning.  In  going  for  a  day's  tramp,  on  a 
Sunday  or  a  holiday,  there  is  no  harm  in  getting 
stiff  and  wholesomely  tired;  a  warm  bath  at 
bedtime  will  set  that  right.  But  when  there  is  to 
be  a  walking  trip  there  should  be  no  more  than 
five  miles  the  first  day,  ten  the  next,  fifteen  the 
third;  after  which  breaking-in  one  may  begin 
at  dawn  and  foot  it  until  he  is  canopied  by  the 
stars.  Nor  will  any  harm  come  to  him,  but  much 
good  and  happiness  and  promise  of  length  of  days. 

The  way  to  walk  is  to  throw  back  your  shoulders 
military  fashion,  the  chest  out,  the  pectorals 
expanding,  the  nostrils  dilating,  the  mouth  closed, 
the  head  erect,  the  arms  swinging  halfway,  but 
not  like  a  windmill.  Let  your  mind  be  diverted 
by  the  ever-changing  scenery  along  the  road; 
talk  to  the  farmer  of  his  fields,  praise  his  pigs, 
ask  his  good  wife  for  a  drink  from  her  spring, 
give  her  some  of  the  news,  for  which  she  is  so 
hungry,  of  what  is  going  on  in  the  world.  Nothing 
else  will  so  surely  get  the  cobwebs  out  of  the 
brain,  nothing  else  will  so  liberally  broaden  your 
sense  of  humanity.  The  clear  sky,  the  bracing 
breeze,  the  rustling  boughs,  the  laughing  waters,  the 
birds,  their  throats  simply  bursting  with  melody — 
these  our  brethren,  who  should  be  our  familiars, 
are  calling.  Go  forth,  brother,  and  walk  among 
them;  go,  sister,  out  into  the  sunshine  and  mingle 
with  them. 

129 


WHY  DIE  SO  YOUNG? 

For  a  walking  trip  very  little  paraphernalia  is 
necessary.  A  stout,  easy  pair  of  shoes  is  essential — 
such  as  have  been  tried  out  at  least  a  week  before- 
hand. The  feet  must  be  well  nursed,  bathed,  and 
vaselined  if  need  be,  at  the  end  of  the  day,  so  that 
one  shall  not  become  a  tenderfoot.  Many  a 
walking  trip  has  gone  to  pieces  the  first  day  or 
two  by  reason  of  blistered  feet. 

A  real  wayfarer  who  is  not  too  fussy  and  of 
reasonably  democratic  tendencies  can  find  a 
good  lunch  almost  anywhere  on  the  road.  A 
favorite  refreshment  of  Weston's  was  an  egg 
beaten  up  in  a  cup  of  coffee.  A  cake  of  chocolate — 
a  most  sustaining  food — hi  the  pocket  will  never 
be  amiss.  And  be  sure  to  take  along  a  foot  or  so 
of  tubing  through  which  you  can  quaff  delicious 
Adam's  ale  from  any  pure  wayside  stream.  Some 
of  my  own  most  agreeable  recollections  are  of 
my  seat  atop  a  convenient  barrel  in  any  crossroad 
or  country  store,  crackers  and  cheese  in  one  hand 
and  a  bottle  of  tonic  (ginger  ale  or  sarsaparilla 
with  a  straw  in  it)  in  the  other  hand,  wTith  discus- 
sions of  the  perversities  of  our  political  system 
with  the  congregated  rural  citizenry. 

As  to  companions  on  the  walk.  In  a  party 
one  can  always  find  a  congenial  companion  of 
either  sex.  But  if  there  are  only  two  of  you  be 
sure  your  man  is  agreeable;  otherwise  there  is 
no  torture  so  exquisite  as  a  day's  walk  in  his 
company.  If  you  are  not  absolutely  certain  on 
this  point,  go  alone;  you  will  be  surprised  what  a 
good  sort  of  fellow  you  will  then  become  acquainted 
with.  More  than  this;  after  hours  of  social  com- 
munion with  nature  you  may,  come  twilight,  find 

130 


YOUTH 

yourself,  Enoch-like,  walking  in  most  comfortable 
intimacy  with  the  Almighty. 

PHYSICAL   TRAINING 

While  thus  extolling  walking  I  am  not  decrying 
other  exercises  and  sports — boating,  boxing,  tennis, 
baseball,  cricket,  and  the  like;  nor  am  I  forgetting 
croquet.  When  judiciously  taken  these  are  all 
most  salutary.  Exercise  develops  and  strengthens 
the  mental  processes;  Hazlitt  appreciated  that 
fact.  The  brain  out  of  which  thought  is  evolved 
(we  know  not  precisely  how)  is  as  much  a  bodily 
organ  as  is  the  liver  or  the  lungs.  Much  of  our 
thinking  (we  do  not  know  how  much)  is  really  a 
physical  process  during  which  the  vital  stores  of 
every  organ  are  drawn  upon.  The  energy  which 
makes  clear  thinking  possible  depends  largely  on 
the  bodily  vigor.  When  physical  disease  impairs 
the  tissues  the  mental  processes  suffer.  We  have 
noted  how  muscular  activity  develops  both  the 
nervous  and  the  muscular  systems.  The  muscles 
are  the  special  organs  of  volition,  the  one  part  of 
the  body  which  the  brain  can  directly  command 
and  act  on.  The  feeble-minded  child  is  clumsy  in 
the  use  of  his  muscles;  the  right  development  of 
the  normal  child  is  indicated  by  increased  accuracy 
and  delicacy  of  muscular  control. 

Physical  training  is,  then,  to  a  considerable 
degree,  mental  training  as  well.  Much  thought 
(of  course  not  all)  that  we  used  to  call  reason  is 
just  feeling;  and  much  of  our  conduct,  many  of 
out  activities,  are  due  more  to  desire,  sentiment, 
and  habit,  than  to  innate  reason.     We  lead  to  a 

131 


WHY  DIE  SO  YOUNG? 

very  considerable  extent  a  cerebrumless  existence. 
The  youth  well  trained  all  around,  physically  and 
mentally,  has  his  activities  well  organized  for  his 
mature  needs.  The  same  is,  of  course,  true  for  the 
schoolgirl  and  the  young  woman. 

Many  intellectual  men  fail  for  lack  of  staying 
stuff.  Many  are  timid  and  irresolute  because 
they  lack  the  physical  driving  power;  theirs  is 
a  shoddy  nervous  system,  a  melancholy  handicap, 
as  we  shall  see.  Much  loose  thinking,  much  rabid 
and  false  thinking,  is  due  to  loose  drilling  of  the 
bodily  forces  in  childhood  and  youth.  Enthusiasm, 
self-confidence,  the  spirit  of  adventure,  alertness, 
promptness,  unselfishness,  quick  judgment,  are 
all  qualities  to  be  attained  on  the  field  of  games  and 
sports. 

THE  MILITIA 

Military  drill  makes  splendidly  for  the  sane 
mind  in  the  sound  body.  The  war  just  ended,  so 
fraught  with  suffering  and  so  death-dealing,  has  in 
any  event  turned  many  a  slouching,  mediocre, 
useless  apology  of  a  man  into  a  superb  specimen 
in  whom  we  have  now  reason  to  glory — every 
fiber  of  his  body  trained  to  the  finger  tips,  and 
from  the  toes  up  to  every  eye  muscle  trained 
and  habituated  to  prompt  obedience,  to  team  work, 
to  courage  and  right  living  of  the  noblest  sort. 
Now  that  the  war  is  over  it  is  to  be  hoped  that 
our  before-the-war  National  Guard  of  citizen 
soldiery  will  be  redeveloped  and  restored  to  its 
fine  old  status,  its  fresh  nucleus  our  boys  returned 
from  "over  there,"  every  community  in  the  land 
having  its  militia  body. 

132 


YOUTH 

Young  men,  go  into  the  militia.  It  is  really 
amazing  the  amount  of  health,  physical  and 
mental — yes,  and  spiritual,  too — and  what  fun 
you  can  get  out  of  a  good  regiment.  I  write  from 
experience,  having  been  a  National  Guardsman. 
In  the  awkward  squad  you  are  introduced  to  a 
fine  system  of  gymnastics,  in  which  nearly  every 
muscle,  every  organ  and  cell  in  your  make-up,  gets 
a  chance.  You  assume  the  position  of  a  soldier, 
and  then  perhaps  for  the  first  time  in  your  life, 
you  enjoy  a  delicious  sense  of  anatomical  symmetry 
and  completeness.  Never  again  the  ignoble  shuffle, 
the  stooping  shoulders,  the  hands  in  the  trousers 
pockets.     And  the  drills ! 

For  an  hour  and  a  half  you  stand  to  the  limit 
of  your  inches — shoulders  back,  head  up,  chin 
straight  out,  eyes  to  the  front;  your  movements 
are  timed  and  measured  and  rhythmed  for  you; 
you  enjoy  the  mental  relaxation  of  having  no 
initiative  of  your  own,  of  doing  precisely  what 
you  are  told  and  of  having  some  one  else  for  the 
time  being  order  your  movements  for  you.  You 
learn  discipline.  How  valuable  the  lesson!  You 
come  to  realize  that  he  who  would,  in  mature  life, 
direct  others  must  himself  first  learn  how  to  obey. 

Soon  you  are  given  your  piece  to  carry;  this 
seems  to  you  to  have  the  weight  of  a  young  pine 
tree,  and  at  the  start  you  manipulate  your  weapon 
with  the  airy  grace  of  a  dancing  bear  balancing  his 
pole.  After  the  drill  you  go  home,  bathe,  sleep — 
the  sleep  of  the  more  or  less  righteous,  but  sound, 
at  any  rate — and  you  awake  with  an  appetite,  a 
sense  of  physical  well-being,  and  a  clearness  of 
mind    such    as    are    perhaps    entirely    novel    and 

10  133 


WHY  DIE  SO  YOUNG? 

certainly  most  happy  experiences.  You  become 
one  of  a  hundred  splendid  fellows — sound,  clean, 
manly,  wholesome.  Among  such  your  mind  and 
body,  your  morals,  too,  have  got  to  be  right.  And, 
what  is  in  itself  worth  all  the  rest  of  the  game, 
you  will  learn  also  why  the  hat  has  got  to  be 
removed  when  the  flag  passes. 

THE   HYGIENIC   LIFE 

I  am  here  most  earnestly  urging  youth  to  get 
the  habit  of  living  the  physiological,  the  hygienic, 
the  healthful  life. 

To  live  this  one  must  bathe  well,  eat  slowly 
and  not  excessively  three  meals  of  wholesome  food 
daily;  one  should  be  in  the  sunshine  a  great  deal; 
should  drink  at  least  half  a  dozen  glasses  of  water 
the  day;  should  avoid  dusty,  damp,  and  foul  air; 
go  to  bed  so  as  to  be  sure  of  eight  hours'  sleep. 
One  should  wear  underclothing  that  is  all  wool 
or  as  near  all  wool  as  possible,  all  the  year  round; 
thick  in  winter,  thin  in  summer.  Warm  footwear 
and  stout,  water-tight  shoes  are  essential.  Tobacco 
had  best  be  let  alone — by  the  young,  anyway. 
Alcohol  should  be  taken  very  moderately,  if  at  all, 
and  never  without  a  bite  of  food  at  the  time  of 
drinking.  The  well,  indeed,  never  need  alcohol; 
the  elderly  and  the  feeble  may  have  occasional 
use  for  it. 

Fresh  air  and  lots  of  it  are  necessary  to  the 
hygienic  life.  Rise  early;  go  to  bed  early;  and 
in  the  mean  time  keep  yourself  occupied.  Wrater 
and  bread  sustain  life,  but  pure  air  and  sunlight 
are  indispensable  to  health.    Frugality  and  sobriety 

134 


YOUTH 

are  the  best  assurance  for  a  long  life.  Cleanliness 
preserves  from  rust;  the  best  kept  machines  last 
the  longest.  A  sufficiency  of  rest  repairs  and 
strengthens;  too  much  rest  weakens  and  makes 
for  flabbiness.  He  is  well  clothed  who  keeps  his 
body  sufficiently  warm,  safeguarding  it  from  all 
abrupt  temperature  changes,  while  at  the  same 
time  preserving  perfect  freedom  of  motion.  Live 
in  a  house  that  is  clean  and  cheerful;  this  makes 
for  a  happy  and  a  healthful  home.  The  mind 
reposes  and  resumes  its  edge  by  means  of  relaxa- 
tion and  wholesome  amusement;  but  excess  opens 
the  door  to  the  passions  and  these  attract  the 
vices.  Judicious  pleasures  conduce  to  love  cf 
life,  and  love  of  life  is  the  half  of  health;  on  the 
other  hand,  sadness  and  gloom  help  on  old  age. 
If  it  is  your  brain  that  feeds  you,  do  not  allow 
your  arms  and  legs  to  become  stiffened  beyond  the 
possibility  of  use.  Do  you  dig  for  a  livelihood? 
Do  not  then  omit  to  burnish  your  intellect  by  good 
reading  and  thereby  to  elevate  your  thoughts. 

I  cannot  imagine  a  finer  ideal  of  the  healthful 
life  to  set  before  young  people  than  this  of  Huxley: 

"That  man,  I  think,  has  a  liberal  education 
whose  body  has  been  so  trained  in  youth  that  it 
is  the  ready  servant  of  his  will  and  does  with 
ease  and  pleasure  all  that  as  a  mechanism  it  is 
capable  of;  whose  intellect  is  a  clear,  cold  logic 
machine,  with  all  its  parts  of  equal  strength  and 
in  smooth  running  order;  ready,  like  a  steam 
engine,  to  be  turned  to  any  kind  of  work  and  to 
spin  the  gossamers  as  well  as  to  forge  the  anchors 
of  the  mind;  whose  mind  is  stored  with  the  knowl- 
edge of  the  great  fundamental  truths  of    Nature 

135 


WHY  DIE  SO  YOUNG? 

and  the  laws  of  her  operations;  one  who,  no 
stunted  ascetic,  is  full  of  life  and  fire,  but  whose 
passions  have  been  trained  to  come  to  heel  by  a 
vigorous  will,  the  servant  of  a  tender  conscience; 
one  who  has  learned  to  love  all  beauty,  whether 
of  nature  or  of  art,  to  hate  all  vileness,  and  to 
esteem  others  as  himself." 

BACK   TO   THE   LAND 

It  is  most  depressing,  in  the  country  region 
where  I  am  summering,  to  ride  past  countless 
acres  of  abandoned  farm  land,  the  bosom  of 
Mother  Earth,  whence  come  all  our  material 
blessings,  the  source  of  all  our  wealth,  all  un- 
touched. Our  former  Secretary  of  the  Interior, 
Franklin  K.  Lane,  would  have  our  government 
provide  land  settlements  for  our  soldiers  and 
sailors  who  served  in  the  war.  Millions  of  acres 
are  planned  to  be  irrigated;  other  millions  of 
acres  of  swamp  land  are  to  be  reclaimed;  still 
other  millions  of  acres  of  arid  land  are  to  be  cleared 
off  for  agricultural  purposes;  and  land  not  fit 
for  plowing  is  to  be  used  for  stock  raising.  Our 
honorably  discharged  soldiers  and  sailors  would 
work  at  good  pay  on  this  vast  reclamation  scheme; 
and  afterward  to  those  good  men  would  be  sold, 
to  be  paid  for  on  installments,  the  land  they  are 
working  and  all  necessary  farm  implements  and 
paraphernalia. 

He  who  works  for  a  wage  is  indeed  honorably 
occupied.  And  yet  it  is  hardly  possible  for  any 
man,  however  sincere  his  intentions,  to  do  for 
another  or  for  a  corporation  all  that  he  would  and 

m 


YOUTH 

could  do  for  himself.  It  is  simply  not  m  human 
nature.  More  than  a  century  ago  this  social  and 
economic  fact  was  recognized  by  the  traveler, 
Arthur  Young,  when  he  wrote  of  a  certain  district 
in  France: 

An  activity  has  been  here  that  has  swept  away  all  difficulties 
before  it  and  has  clothed  the  very  rocks  with  verdure.  It 
would  be  a  disgrace  to  common  sense  to  ask  the  cause;  the 
enjoyment  of  property  has  done  it.  Give  a  man  the  secure 
possession  of  a  bleak  rock  and  he  will  turn  it  into  a  garden; 
give  him  a  nine-year  lease  of  a  garden  and  he  will  turn  it  into 
a  desert.  Many  of  the  vineyards  which  greet  the  traveler's 
eye  have  for  their  entire  soil  earth  which  has  been  carried  in 
baskets  up  the  mountain  side  by  the  laborious  owner  of  those 
vineyards.  When  I  used  to  open  my  casement,  between  four 
and  five  in  the  morning,  to  look  out  upon  the  lake  and  the 
distant  Alps,  I  saw  the  laborer  in  his  fields;  and  when  I  re- 
turned from  an  evening  walk  long  after  the  sunset,  there  was 
the  laborer  still  mowing  his  grass  or  tying  up  his  vines. 

He  that  owns  no  more  than  an  acre  ("ten  are 
ample")  and  a  cow,  under  just  and  equal  laws, 
knows  that  every  stroke  of  his  arm  is  creating 
values  which  he  and  his  family  will  enjoy  to  the 
uttermost.  Long  is  his  day's  work;  but  its  close 
does  not  find  him  exhausted.  He  takes  care  to 
prevent  the  injury  and  the  waste  of  what  is  his 
own.  He  stores  and  houses  his  crops.  And  with 
the  oncoming  of  the  snows  he  is  busy  repairing  his 
farm  tools  and  his  implements,  putting  to  order 
his  barn  and  his  chicken  houses,  is  occupied 
contentedly  with  a  thousand  things  that  need 
attention  by  way  of  preparation  for  the  spring 
plowing. 

And  during  the  winter  nights  there  is  the  helmet 
with  the  bullet  hole  through  it,  taken  from  the 

137 


WHY  DIE  SO  YOUNG? 

Boche  in  the  Argonne,  and  above  it  Old  Glory 
that  was  carried  wherever  the  fighting  was  done. 
And  in  the  hearth  below,  the  crackling  logs  are 
lighting  up  the  wife's  winsome  face;  and  surround- 
ing them  that  scale  of  olive  branches  constantly 
ascending  as  the  blessed  years  go  on! 

Such  is  the  life  for  the  returned  doughboy; 
the  life  so  conducive  to  health,  to  happiness,  and 
to  length  of  days;  the  life  for  the  real  man.  Go 
to  it,  brother! 

MARRIAGE 

And  the  wife.  When  should  a  man  take  unto 
himself  a  wife;  and — with  precipitate  haste  I 
add — when  should  a  woman  take  unto  herself  a 
husband?  There  is  hardly  any  subject  more 
fraught  with  diversity  of  opinion.  At  the  one 
extreme  there  is  the  monosyllabic  advice  of  Punch: 
"To  those  about  to  marry,  Don't."  At  the  other 
stands  the  dear  old  Vicar  of  Wakefield,  whose 
homilies  were  so  insistently  for  early  marriage, 
the  earlier  the  better.  From  the  physician's  view- 
point there  are  weighty  considerations  in  favor  of 
fairly  early  marriages.  "At  eighteen  under  the 
canopy,"  states  the  Talmud;  and  all  forms  of  re- 
ligion may  well  respect  a  saying  out  of  the  wisdom 
accumulated  during  forty  centuries  by  the  teachers 
of  the  Jewish  faith.  One  must,  however,  note  that 
the  Jewish  teaching  had  its  origin  in  or  near  the 
East,  where  physical  development  is  more  rapid 
than  in  the  Occident,  and  where  very  early 
marriages  have  from  time  immemorial  been  the 
custom.  Among  us  it  were,  in  most  cases,  best 
for  a  man  not  to  marry  under  twenty-five  nor  a 

133 


YOUTH 

woman  under  twenty-one.  The  strain,  both 
physical  and  emotional,  upon  the  immature  is 
like  to  be  very  great,  sometimes  to  be  grave; 
undoubtedly  from  this  cause  some  men  and  women 
become  old  before  there  is  need.  No  girl  certainly 
is  ever  physically  mature  until  her  twenty-first 
year;  and  it  were  cruel  indeed  to  impose  upon 
her,  before  that  age,  the  perils  and  the  physical 
stresses  of  motherhood. 

The  present  tendency  in  civilization  seems  to  be 
for  very  late  marriages,  the  man  at  forty,  the 
woman  at  thirty — a  tendency  sought  to  be  justified 
for  social  and  economic  reasons.  A  deplorable 
status,  in  my  opinion,  which,  I  believe,  is  that  of 
most  medical  men. 

There  has  been  no  more  sympathetic  or  pro- 
found observer  of  human  nature  and  of  human 
conduct  than  Lecky,  who  considered,  in  his  Map 
of  Life,  that  the  age  suitable  for  marriage  depends 
largely  on  individual  circumstances.  The  ancients 
placed  it  far  back  in  the  man's  case;  and  they 
desired  a  great  difference  in  the  ages  of  the  man 
and  the  woman.  Plato  would  have  the  man 
marry  between  thirty  and  thirty-five;  Aristotle 
was  for  thirty-seven;  girls  those  philosophers 
advised  to  be  married  at  eighteen  or  twenty.  Their 
viewpoint,  however,  was  exclusively  that  of  the 
state.  They  looked  upon  marriage  solely  as  a 
means  of  providing  healthy  citizens  and  a  powerful 
body  politic;  and  they  recognized  but  little  the 
sentimental  and  lovely  aspects  of  the  marriage 
relation.  "Yet  few  things,"  observed  Lecky,  "are 
so  important  in  marriage  as  that  the  man  should 
bring  into  it  the  freshness  and  the  purity  of  an 

139 


WHY  DIE  SO  YOUNG? 

untried  nature;  and  that  the  early  poetry  and 
enthusiasm  of  life  should  to  some  degree  at  least 
blend  with  the  married  state.  Nor  is  it  desirable 
that  a  relation  in  which  the  formation  of  habit 
plays  so  large  a  part  should  be  deferred  until 
character  has  lost  its  flexibility  and  until  habits 
have  been  irretrievably  hardened." 

On  the  other  hand,  marriage  should  not  be 
entered  into  at  an  age  when  neither  partner  has 
any  real  knowledge  of  the  world;  only  too  often 
do  such  marriages  involve  illusions  and  leave 
regrets.  Some  kind  of  knowledge,  such  as  that 
given  by  extended  travel,  are  far  more  easily 
acquired  before  than  after  marriage.  Usually 
very  early  marriages  are  improvident,  made  with 
no  sufficient  provision  for  the  children,  and  im- 
mature, bringing  with  them  serious  physical  ills. 

Thus  can  no  general  or  fixed  rule  be  laid  down; 
and  what's  more,  if  there  were,  it  would  be  pretty 
generally  disregarded.  Moralists  have  chiefly 
dilated  on  the  dangers  of  deferred  marriages; 
economists  on  the  evils  of  improvident  unions. 
Each  man's  and  woman's  circumstances  must  de- 
termine the  course.  In  most  civilized  countries 
the  prevailing  tendency  is  now  for  postponement. 
Among  the  rich  the  higher  standards  of  luxury 
and  of  requirements,  the  bachelor  men's1  apart- 
ments and  the  bachelor  girls'  clubs;  the  "business 
necessity"  by  which  women  become  engaged  in 
pursuits  which  from  the  race's  beginning  have  been 
natural  only  to  masculinity;  and  the  diminished 
place  which  the  normal  emotions  and  tendernesses 
are  taking  in  life — are  considerations  which  would 

1  Bachelors,  "those  pirates  of  love  that  know  no  duty." — Fincr, 

HO 


YOUTH 

account  for  this  setting  forward  the  time  of 
marriage.  The  poor,  as  has  always  been  the 
case,  are  unaffected  by  such  considerations.  To- 
day, as  ever,  they  marry  fairly  early;  being  un- 
sophisticated, it  remains  for  them  only  to  be 
natural,  to  fall  in  love,  and  to  practice  the  dear  old 
homely  and  domestic  virtues.  Nor  do  they  con- 
template divorces,  or  sex  rights,  or  feministic 
aspirations,  or  domestic  relations  courts,  or  tempera- 
mental differences.  Such  luxuries,  fortunately  for 
them,  are  beyond  their  resources,  either  of  pocket 
or  of  disposition. 

For  most,  the  marriage  of  the  man  at  twenty- 
five,  of  the  woman  at  twenty-one  or  thereabouts, 
would  appear  to  be  the  part  of  wisdom. 


IV 

MATURITY 

"Then  the  soldier, 
Full  of  strange  oaths,  and  bearded  like  the  pard, 
Jealous  in  honor,  sudden  and  quick  in  quarrel, 
Seeking  the  bubble  reputation 
Even  in  the  cannon's  mouth." 

HUMAN    WEAR    AND    TEAR 

BEFORE  the  war  a  woeful  number  of  our 
young  men  were,  as  to  their  physical  makeup, 
most  inefficient  machines,  poorly  constructed, 
working  badly,  and  in  danger,  in  the  saddest  way, 
of  landing  upon  the  scrap  heap  long  before  the 
allotted  human  span.  The  surgeons  who  examined 
our  drafted  men  (also  those  far  more  numerous  men 
unfit  for  any  military  service)  emphasized  this 
deplorable  situation;  long  before  the  war  they 
established  such  facts,  which  no  one  would  consider. 
Long  before  the  war  it  was  known,  for  instance, 
that  of  twenty  thousand  men  and  women  who 
applied  for  life  insurance,  imagining  themselves 
in  sufficiently  good  health  to  get  policies,  43  per 
cent  were  found  to  have  some  kidney  or  heart 
or  arterial  ailment,  and  were  either  turned  down 
absolutely  or  were  assessed  higher  premiums  than 
ordinarily;  that  some  seven  hundred  thousand 
working   people — and    who    among    us    is    not    a 

142 


MATURITY 

worker — die  when  there  is  no  occasion,  long  before 
their  time,  of  preventable  diseases.  Recently 
four  hundred  persons  were  examined,  about  one- 
third  of  them  women.  Ninety-eight  per  cent  of 
them  showed  some  physical  imperfection;  51  per 
cent  were  in  actual  need  of  doctoring;  33  per  cent 
were  unaware  of  any  physical  impairment — theirs 
were  masked  symptoms. 

The  simple  truth  is  that,  as  a  whole,  we  Ameri- 
cans are  the  most  extravagant  lot  on  the  planet, 
and  in  nothing  more  so  than  as  to  our  flesh-and- 
blood  resources.  It  is  precisely  as  if  many  thousands 
of  our  people  were  falling  blindly  over  a  dreadful 
precipice,  at  the  bottom  of  which  are  the  best 
equipped  ambulances  in  the  world,  to  take  them 
off  to  the  most  magnificent  and  best  surgeoned 
hospitals  in  the  world,  after  they  have  been  hurt. 

So  far  as  the  limits  of  this  book  will  permit, 
I  am  now  going  to  help  put  a  railing  around  this 
precipice  and  to  hoist  the  necessary  danger  signals. 
And  this  to  the  end  that  the  finest  piece  of  ma- 
chinery in  the  cosmos,  the  superb  human  body, 
shall  not  fall  over,  either  to  be  smashed  beyond 
repair  or  to  be  mended  to  70  or  50  or  30  per  cent 
of  its  former  efficiency — with  a  much  shorter 
time  to  run  than  if  it  had  remained  whole  and 
unimpaired.  What  is  such  a  railing?  What  are 
the  danger  signals?  They  are  manufactured,  as 
we  shall  see,  according  to  specifications  prepared 
in  the  most  beneficent  of  all  sciences,  that  of 
disease  prevention.  And  they  are  based  on  the 
principle  that  an  ounce  of  prevention  is  worth 
tons  of  regret,  of  most  unnecessary  suffering,  of 
vast  material  loss.     And  I  will  beg  to  disregard 

143 


WHY  DIE  SO  YOUNG? 

the  protests  of  certain  ostrichlike  folk  who  would 
not  have  such  danger  signals  hoisted  because  they 
would  frighten  people  so.  As  if  one  should  say, 
"Don't,  in  the  name  of  mercy,  put  a  lighthouse 
on  that  reef;  it  would  show  the  people  aboard 
ship  what  dreadful  peril  they  are  in!" 

Efficiency  has  been  the  great  twentieth-century 
slogan.  But  doctors  have  realized  full  well  that 
any  efficiency  worth  talking  about  is  not  to  be 
attained  unless  the  human  machine  is  sound  in 
all  its  parts,  its  organs  and  tissues  well  adjusted 
to  one  another,  properly  fueled  with  wholesome 
meat  and  drink,  not  strained  beyond  its  factors 
of  safety,  and  running  smoothly. 

I  will  now  indicate  a  few  of  the  thirty-odd 
places  in  the  human  machinery  where  doctors 
are  accustomed  to  find  loose  cogs,  rusted  plates, 
clogging  clinkers,  and  adjustments  out  of  gear. 

THE   STOUT   AND   THE   LEAN 

Any  marked  discrepancy  in  the  weight,  as 
compared  with  one's  height  and  years,  should 
give  concern. 

Weight  much  above  the  average,  especially 
when  associated  with  that  bay-window  style  of 
architecture,  should  invite  consideration  of  the 
condition  of  the  liver,  the  kidneys,  the  arteries, 
the  heart,  and  the  digestive  apparatus.  The 
tendency  to  obesity  should  be  successfully  com- 
bated, although  it  almost  never  is,  especially  if 
there  is  a  family  temperament  that  way.  Weight 
is  indeed  oftentimes  reduced  successfully  enough, 
but  generally  not  for  long,  and  in  many  cases 
because  "the  sufferer"  will  not  exercise  the  will 

144 


MATURITY 

power  to  stay  reduced  by  keeping  away  from  the 
flesh  pot  and  by  persevering  in  the  banting  regime. 
More  of  this  in  another  place. 

In  those  under  weight,  before  they  are  thirty,  we 
have  to  think  of  the  possibility  of  tuberculosis. 
Very  many  such  people  will  go  to  a  doctor  with  a 
history  of  having  had  frequent  and  neglected 
colds.  Or  there  are  those  who  have  been  weakened 
by  some  such  serious  disease  as  typhoid  fever  or 
malaria  or  pneumonia,  and  they  have  not  been 
willing  or  perhaps,  sad  to  say,  able  to  take  the 
time  for  a  proper  convalescence.  Others  are 
exhausted  from  overwork,  or  have  blood  poverty, 
or  suffer  from  indigestion,  or  do  not  eat  enough. 
For  such  reasons  people  are  thin.  How  can  such 
as  are  otherwise  in  good  health  take  on  enough 
weight,  in  a  perfectly  natural  way,  to  bring  them 
up  to  the  normal  for  their  age  and  height? 

Assume  such  a  one  takes  for  breakfast  a  cup 
of  coffee,  an  egg,  and  a  roll.  Instead  of  mostly 
coffee,  let  him  take  two  parts  of  milk  and  one  of 
coffee;  also  a  great  deal  of  butter  on  his  bread; 
two  eggs  instead  of  one,  and  butter  with  them. 
Lunch  in  like  manner,  taking  more  cream  and 
more  sugar.  And  let  him  make  his  drinks  more 
nutritious;  instead  of  alcohol,  which  decreases 
rather  than  adds  to  weight,  egg  lemonades  and 
milk  shakes  are  best.  Three  good  meals  a  day 
with  a  cup  of  cocoa,  bread  and  butter  (sugar  on 
the  butter)  between  meals.  Let  him  aim  for  a 
quarter  pound  of  butter  a  day — butter  on  oatmeal, 
other  cereals,  bread,  with  eggs — everything.  Sugar 
is  fattening,  too;  be  sure,  however,  to  take  the 
sweets  at  the  end  of  the  meal.    Potatoes  and  all 

145 


WHY  DIE  SO  YOUNG? 

starchy  foods,  well  chewed,  are  also  fattening. 
Moderate  exercise,  deep  breathing,  and  sleeping 
eight  hours  the  night  (in  the  fresh  air),  with  a 
twenty-minute  siesta  in  the  afternoon  —  these 
agencies  also  conduce  to  the  taking  on  of  weight. 

THE   BLOOD   PRESSURE 

The  blood  pressure,  taken  by  means  of  the 
sphygmomanometer,  gives  most  valuable  infor- 
mation. The  doctor  by  using  this  instrument  is 
able  to  ascertain  with  accuracy  (such  as  his  finger 
on  the  pulse  could  not  approach)  the  systolic 
and  the  diastolic  pressures.  Roughly  speaking, 
the  normal  systolic  approximates  100  plus  one's 
age;  and  the  diastolic  in  health  registers  from  30 
to  50  points  below  the  systolic.  The  systolic 
being  120  and  the  diastolic  80,  one  then  has  a 
pressure  pulse  of  40 — that  is,  the  difference  between 
the  upper  and  lower  points.  Such  1,  2,  3  relation 
(40,  80, 120)  should  obtain  for  most  healthy  people. 
If  this  does  not  hold  fairly  well,  imperfect  circulation 
and  poor  bodily  hose  pipe  are  in  evidence. 

A  high  diastolic  pressure  is  especially  serious 
as  to  the  heart.  Over  100  is  significant  of  that 
precious  organ  being  overworked  by  reason  of  its 
having  to  force  blood  through  hardened  arteries. 
A  diastolic  of  110  is  a  menace;  a  figure  above  that 
a  grave  indication  of  hypertension. 

One  of  the  commonest  causes  of  heightened 
blood  pressure  is  excess  in  eating  and  drinking. 
The  toxins  from  excess  food  are  irritating  and 
poisonous  to  the  system;  therefore  the  first  step 
we  have  to  take  toward  improving  and  lowering 
excessive  blood  pressure  is  to  diminish  the  meats 

146 


MATURITY 

and  eggs  in  the  dietary,  or,  if  the  pressure  is 
serious,  to  remove  these  substances  entirely  from 
one's  food.  Alcohol  affects  the  appetite  by  increas- 
ing the  amount  of  food  taken;  also,  by  interfering 
with  normal  digestion  it  indirectly  disturbs  the 
orderly  working  of  the  bodily  processes;  it  should, 
therefore,  be  cut  out.  Drugs  and  other  substances 
taken  injudiciously  or  without  medical  advice 
often  act  injuriously.  Caffein,  thein,  and  nicotine, 
are  found  in  coffee,  tea,  and  tobacco;  when  taken 
excessively,  they  have  a  bad  effect  on  the  blood 
pressure.  They  must  either  be  given  up  or  taken 
in  great  moderation — one  cup  of  coffee  at  break- 
fast, one  cup  of  tea  or  coffee  at  supper,  tobacco 
best  not  at  all. 

There  is  a  distinct  relation  between  hard  work  and 
great  anxiety,  on  the  one  hand,  and  high  blood  pres- 
sure on  the  other.  Workers  in  lead  and  sometimes 
diabetics  are  likely  to  suffer  thus.  Hardened  arteries 
and  kidney  disease  make  a  bad  combination. 

Hypertension  sufferers  must,  therefore,  be  cau- 
tioned against  the  tendency  to  go  the  pace  that 
kills,  severe  athletic  competition,  recreation  ex- 
cesses, overwork,  overeating,  overdrinking,  and 
other  untoward  factors  above  mentioned,  so 
that  their  hypertension  may  not  become  pro- 
longed and  increased  with  the  months  and  the 
years,  and  so  that  they  may  be  guarded  especially 
against  apoplexy.  Patients  having  suffered  in- 
fectious diseases  should  have  a  slow  convalescence, 
during  which  they  are  carefully  watched  against 
too  great  strain  on  their  weakened  organs.  On  the 
other  hand,  the  doctor  can,  by  means  of  that 
instrument  with  the  unpronounceably  long  name, 

147 


WHY  DIE  SO  YOUNG? 

discern  when  hypotension  (lowered  blood  pressure) 
is  registered.  Then  latent  tuberculosis  is  to  be 
examined  for,  also  "blood  disease,"  neurasthenia, 
and  the  like.  Also  the  effects  of  hemorrhage  can 
thus  be  gauged. 

But  our  management  of  hypertension  must  be 
judicious.  We  must  not,  all  of  a  sudden,  change 
radically  the  patient's  whole  manner  of  life.  We 
must  in  the  first  place  thoroughly  cleanse  out  the 
digestive  tract,  to  get  rid  of  as  much  of  the  toxins 
as  possible.  The  eliminative  organs  must  work 
right.  The  drinking  of  milk  should  be  encouraged, 
at  least  a  quart  a  day.  Hot  baths  from  time  to 
time  are  good.  For  insomnia  a  glass  of  hot  milk, 
with  perhaps  a  dose  of  sodium  bromide  (15  grains) 
in  it.  WThen  there  is  a  sense  of  fullness  in  the 
head  with  marked  headache,  general  distress,  and 
perhaps  tingling  of  the  fingers,  get  the  doctor  at 
once,  especially  for  a  sufferer  past  forty.  If  the 
doctor  wants  to  blood-let  in  such  a  case,  do  not 
interfere  with  him.    He  knows  his  business. 

A  patient  with  moderate  hypertension,  but 
otherwise  feeling  himself  in  fair  health,  should 
rest,  if  possible,  on  his  back  an  hour  in  the  after- 
noon, and  Sunday  should  be  absolutely  a  day  of 
rest  for  him.  Drugging  for  hypertension  is  a 
matter  no  layman  should  attempt;  only  the  doctor 
should  prescribe,  deciding  for  each  case  on  the 
individual  merits. 

AUTO-INTOXICATION 

Autotoxemia  is  the  poisoning  of  the  bodily 
tissues  through  the  absorption  of  and  circulation 
in  the  blood  of  the  toxic  (poisonous)  products  of 

148 


MATURITY 

putrefaction  in  the  intestines.  This  putrefaction 
comes  chiefly  from  the  excess  of  proteid  elements 
or  the  imperfect  digestion  of  those  elements  in  the 
food.  The  proteids  are  mainly  meats,  fish,  eggs, 
oysters,  and  the  like.  The  autotoxemia  sufferer 
should  not  forgo  entirely  such  proteid  foods,  but 
he  should  eat  them  in  great  moderation 

The  torpid  or  the  slow  liver  (hepatic  insufficiency) 
is  a  considerable  factor  in  the  development  of 
autotoxemia;  such  a  liver  fails  to  secrete  enough 
bile,  so  that  intestinal  fermentation  and  putre- 
faction result.  The  toxins  thus  formed  and  thus 
absorbed  occasion  impaired  digestion,  constipation, 
the  muddy  complexion,  frequent  headache,  oc- 
casional dizziness,  mental  dullness,  depression, 
abdominal  distress;  more  indirectly  lumbago, 
rheumatism,  heart  palpitation,  hives,  eczema,  neu- 
ralgia, and  disorders  of  special  organs.  If  the 
condition  continues  unattended  to,  anaemia  (poor- 
bloodedness) ,  neurasthenia,  Bright's  disease,  or 
hardening  of  the  arteries  have  to  be  feared.  Tests 
for  autotoxemia  are  familiar  to  the  physician. 

THE   ATHLETE'S   HEART 

The  athlete's  heart  comes  about  by  reason  of 
incomplete  closure  of  the  cusps  of  the  aortic  valve, 
that  through  which  the  heart  pumps  its  blood  into 
the  aorta,  the  largest  artery  in  the  body.  In  con- 
sequence of  this  valvular  defect  part  of  the  blood 
returns  to  the  heart  instead  of  passing  on  through 
the  aorta  to  the  other  arteries  of  the  body. 

The  cusps  are  ruptured  by  violent  muscular 
efforts,  as  in  lifting,  running,  bicycling,  ski-jumping, 
boxing,  wrestling,  and  more  especially  the  tug-of-war. 

11  149 


WHY  DIE  SO  YOUNG? 

In  most  such  cases,  however,  the  valve  has  been 
weakened  through  some  previous  ailment,  such  as 
rheumatism,  malaria,  typhoid  fever,  or  alcoholism. 

The  returning — regurgitating — blood  clogs  up 
the  heart  chamber;  wherefore  overgrowth — hyper- 
trophy and  dilation  of  that  precious  organ — occurs. 
The  heart  muscle  may  reach  so  great  a  degree  of 
hypertrophy  that  doctors  speak  of  the  cor  bovinum, 
the  bull's  heart.  The  water  hammer  is  character- 
istic of  this  malady,  a  pulse  strong  and  jerky,  but 
collapsing  immediately  under  the  doctor's  fingers 
at  the  wrist.  This  phenomenon  is  by  reason  that 
the  heart  pumps  the  blood  into  the  arteries  with 
much  force,  while  the  blood  come-back  is  almost 
instantaneous. 

There  is  suffered  distressing  and  acute  pain, 
with  flashes  of  light,  ringing  in  the  ears,  and  faint- 
ness  on  rising  suddenly.  Even  the  slightest  exer- 
tion causes  palpitation  and  shortness  of  breath. 
The  neck  vessels  throb.  The  sleep  is  disturbed  by 
dreams  and  nervous  startings,  with  sensations  of 
suffocation. 

No  wonder  such  a  sufferer,  perhaps  the  erstwhile 
idol  of  his  college  by  reason  of  his  athletic  prowess, 
and  one  naturally  rejoicing  in  his  strength,  goes  to 
pieces  in  a  pathetic  way  in  mature  life  and  becomes 
morose  and  morbid.  Such  men  do  well  enough 
if  they  are  content  to  lead  the  quiet  life,  not  to 
overstrain  nor  to  get  excited,  not  to  take  the 
chances  other  men  do  as  to  alcohol,  late  hours, 
and  the  bright  lights — a  blessing  in  disguise,  if 
you  look  at  it  in  the  right  way. 

Athletic  training,  then,  though  admirable  within 
bounds,  is  harmless  only  when  the  heart  muscle 

150 


MATURITY 

has  not  already  been  damaged  by  some  infection, 
or  intoxication,  or  serious  general  disease.  And 
all  training  should  be  stopped  at  once  in  the  event 
of  any  indisposition,  such  as  we  have  considered, 
in  the  candidate's  past. 

THE  USE  AND  ABUSE  OF  DRUGS 

Drugs  are  oftentimes  used  with  so  little  dis- 
crimination, with  results  so  unhoped  for,  in  some 
cases  even  fatal,  that  many  people,  some  of  them 
doctors,  have  come  to  believe  it  would  be  better 
for  our  race,  far  better,  if  there  were  no  such 
things  as  drugs  at  all.  This  is,  however,  manifestly 
a  wrong  opinion.  The  benevolent  friar  in  "Romeo 
and  Juliet"  was  right  when  he  went  forth  at  dawn 
to  gather  his  healing  simples  from  out  the  dear 
bosom  of  Mother  Earth,  which  sustains  us  through 
ill  as  well  as  good.  He  had  the  reasonable  idea, 
did  this  sensible  man  of  God,  which  he  no  doubt 
also  had  the  skill  rightly  to  apply.  Henry  Ward 
Beecher  was  as  wise  when  he  declared  that  near  by 
many  a  grave  are  vegetable  and  mineral  substances, 
by  the  virtues  of  which,  had  they  been  rightly 
applied,  had  they  been  used  scientifically — that  is, 
with  knowledge — the  occupant's  obsequies  would 
have  been  considerably  postponed. 

Here  is  sound  sense,  conforming  well  with  the 
fundamental  facts  of  existence.  As  good  sense 
as  when  that  mediaeval  mental  healer,  Carlstadt, 
declared  that  "whoso  falls  sick  shall  take  no 
physic,  but  shall  commit  his  case  to  God."  To 
which  the  more  prescient,  yes,  and  the  godlier 
Luther  rejoined,  "Do  you  eat  when  you  are 
hungry?"     And    the   answer   being   affirmative — 

151 


WHY  DIE  SO  YOUNG? 

as,  indeed,  what  else  could  it  have  been — Luther 
continued,  "Even  so  you  may  use  physic,  which 
is  God's  gift,  just  as  meat  and  drink  are,  or  what- 
ever else  we  use  for  the  preservation  of  life." 

Drugs  must  be  used  with  discrimination  and 
with  definite  application  to  given  ills.  Herein 
lies,  except  for  the  half  a  dozen  household  remedies, 
to  the  use  of  which  we  are  all  accustomed,  the 
doctor's  province  and  no  one  else's.  Drugs  have, 
as  much  as  anything  in  life  can  be  certain,  their 
good  purpose  in  nature.  From  time  immemorial 
they  have  been  taken  into  the  body  for  no  other 
conceivable  reason  than  that  they  have  been 
needed  and  found  salutary  and  corrective.  Many 
of  the  drugs  are  repugnant  to  the  taste,  but  have 
all  the  same  been  persevered  in,  obviously  because 
experience  has  shown  them  to  be  beneficial.  The 
wisdom  of  the  ages  attests  their  efficacy.  Medical 
science  has  studied  throughout  many  centuries 
these  medicaments;  has  formulated  and  crystal- 
lized the  world's  accumulated  knowledge  of  them, 
has  gathered  them  from  whatsoever  remotest  re- 
gions of  the  earth  the  reputation  of  them  has  come. 
Unquestionably  they  are  dangerous  weapons,  these 
drugs,  in  the  hands  of  those  unfamiliar  with  the 
uses  of  them,  in  the  hands  of  those  who  have  not 
learned  their  properties.  But  their  wise  adjustment 
to  individual  needs  is  basic  to  the  rational  practice 
of  medicine. 

For  an  instance  of  the  misuse  of  drugs.  At 
lunch  one  day  the  maid,  who  for  a  stipend  spared 
my  family  the  inconvenience  of  doing  its  own 
reaching,  appeared  with  the  face  of  a  corpse;  her 
eyes,   by   contrast,   of  a  ghastly  luminance,   and 

152 


MATURITY 

her  lips  as  blue  as  ink.  The  reason  for  this  illness 
was  that  I  had  that  morning  received  a  package 
advertising  a  coal-tar  product,  and  containing 
sample  products  which  I  was  asked  to  use  in  my 
practice.  I  threw  all  this  into  the  wastebasket. 
The  maid,  in  tidying  up  my  office,  found  these 
tablets  in  the  box,  labeled  as  being  a  headache  sure 
cure.  She  took  not  one,  but  several,  on  the  some- 
what popular  theory  that  if  one  dose  is  good  for 
a  given  trouble,  reduplications  are  just  so  much 
the  better.  We  got  her  to  bed  at  once  and,  had 
I  not  restored  her,  she  might  have  been  fatally 
poisoned.  Nor  would  hers  have  been  the  first 
case — far  from  it — of  people  throwing  dice  with 
Death,  the  dice  being  loaded  in  favor  of  that 
grim  personage. 

There  are  many  books  on  human  gullibility,  on 
human  folly.  In  these,  however,  one  will  rarely 
come  upon  matter  dealing  with  the  considerable 
human  propensity  to  take  drugs  haphazard.  There 
is  absolutely  nothing  else  which  people  buy  for  their 
personal  use  the  nature  and  ingredients  of  which 
they  do  not  closely  examine  into — nothing  except 
the  substance  they  take  into  their  bodies  when 
they  are  sick;   sick  perhaps  unto  death. 

TEA   AND   COFFEE 

Coffee  and  tea  are  generally  drunk  for  the  pleasure 
and  sense  of  wellbeing  they  give;  yet  both  these 
aromatic  beverages  are  stimulants ;  they  are  not  food. 

When  a  tired  woman  refuses  food,  prefers 
instead  cup  after  cup  of  strong  tea,  she  is  cheered 
and  exhilarated — yes.  and  sometimes  inebriated; 
and  this  to  the  jeopardy  of  nerves  and  muscles, 

153 


WHY  DIE  SO  YOUNG? 

which  must  sooner  or  later  break  down,  if  the 
habit  of  "tea  tippling"  is  persisted  in.  Then 
there  is  a  case  of  neurasthenia  or  hysteria  for  the 
doctor;  possibly  even  a  case  for  the  domestic 
relations  courts,  by  reason  of  temperamental 
incompatibility  thus  induced. 

In  like  manner,  when  a  man  under  stress  of 
business,  or  who  is  going  "the  pace  that  kills" 
drinks  anywhere  up  to  a  dozen  cups  a  day  of 
strong  black  coffee,  to  keep  up  under  the  unnatural 
strain,  he  is  going  to  pay  the  penalty  for  the 
intoxication — for  that  is  what  it  amounts  to — 
some  way  or  other,  sooner  or  later. 

The  natural  forces  of  the  human  body  are  able 
to  do  normally  a  certain  amount  of  work;  and 
their  ability  to  do  this  work  is  directly  in  proportion 
to  the  energy  derived  from  the  food  supply  taken 
into  the  body. 

A  machine  is  kept  going  by  the  fuel  in  the 
engine;  the  machine  may  be  made  to  go  faster 
by  means  of  bellows.  Coal  is  the  fuel;  the  bellows 
stimulate  the  flame.  In  the  man  machine  food 
(meat,  vegetables,  cereals)  is  the  fuel;  tea,  coffee, 
alcohol  are  as  the  bellows — they  are  not  the  fuel. 

No  amount  of  these  stimulants  adds  to  the 
living  tissues  (the  nerves,  the  muscles,  and  the 
organs)  of  the  body;  they  merely  goad  the  nerves, 
muscles,  and  organs  to  undue  effort,  however 
tired  and  unwilling  these  tissues  may  be. 

When  the  stimulant  is  stopped,  or  if,  after  a 
time,  in  spite  of  the  stimulant,  the  exhausted  tissues 
refuse  to  do  their  work,  then  the  weakened  body 
rebels  and  refuses  to  work  again  until  it  has  been 
fully  restored,  recreated,  by  rest,  sleep,  change,  fresh 

154 


MATURITY 

air,  abundance  of  nutritious  food,  and  hygienic  living 
in  general.  If  these  salutary  means  are  not  now 
forthcoming  disease,  perhaps  fatal,  is  inevitable. 

A  certain  amount  of  stimulant  at  rare  intervals, 
when  there  is  much  unusual  stress  or  for  particular 
occasions,  may  do  no  harm.  At  such  times  we 
may  consider  the  stimulants  the  savings  banks 
of  the  tissues.  But  the  pity  of  it  is  that  if  the 
habit  is  once  started  the  ultimate  bad  effects  are 
ignored  in  the  apparent  relief  of  the  moment. 

Besides  the  baneful  stimulative  effects  of  tea, 
tannin  is  developed  in  the  brewing,  and  this  is 
really  harmful  on  account  of  its  strong  astringent 
property,  which  tends  to  injure  the  delicate  gastric 
membrane.  Thus  tired  housewives,  without  know- 
ing it,  may  really  be  drinking  ink,  which  is  a 
solution  of  iron  and  tannin.  The  tea  may  be 
brewed  in  an  iron  kettle  and  left  standing  to 
"take  a  drop  of"  from  time  to  time  throughout 
the  day.  Such  tea  left  standing  is  sure  to  be 
strong  in  tannin,  and  with  the  iron  from  the 
kettle  makes  the  ink.  Or  the  water  in  which  the 
tea  is  brewed  may  be  strong  in  iron  (chalybeate) 
salts.  The  bitter  taste  of  the  tannin  is  disguised 
when  milk  is  used  with  the  tea;  tea  without  milk  or 
cream  may  be  safer  than  tea  with  milk,  because 
without  the  milk  the  bitter  taste  would  make  the  tea 
being  boiled  so  long  unpalatable  and  undrinkable. 

NERVE  TESTS 

People  are  tested  for  mental  exhaustion  (psy- 
chasthenia) ;  for  exhaustion  of  the  nervous  system 
as  a  whole  (neurasthenia);  for  real  structural 
malady  of  the  nervous  mechanism.     The  bodily 

155 


WHY  DIE  SO  YOUNG? 

reflexes  are  taken;  also  the  reactions  of  the  eyes 
(those  windows  of  the  soul)  to  light  and  accommo- 
dation. And  tremors,  inco-ordinations,  and  the 
like  are  ascertained.  Particularly  impressive  are 
found  the  relations  between  eyestrain  and  refractive 
errors  on  the  one  hand  and  headaches,  stomach 
troubles,  and  other  considerable  physical  distress 
on  the  other.  Not  a  few  gastric  "  cancers,"  though, 
sad  to  note,  far  from  all,  have  vanished  on  the 
fitting  of  the  right  glasses. 

THE   SHODDY   NERVOUS   SYSTEM 

We  must  now  consider  some  of  the  nervous 
affections  of  mature  life.  Dr.  Guernsey  Rankin, 
an  English  physician,  has  aptly  written  of  neu- 
rasthenia patients  as  having  "the  shoddy  nervous 
system."  Women  may  be  supposed  to  be  the 
greater  sufferers;  and  yet,  in  a  series  of  ten  cases 
taken  at  random  by  Doctor  Rankin  from  his  files, 
nine  were  of  men  and  but  one  of  a  woman. 

The  basis  of  neurasthenia  is  generally  a  neuro- 
pathic tendency,  either  hereditary  or  acquired. 
The  ordinary  stresses  and  strains  of  life  are  too 
much  for  such  people.  The  tasks  the  most  of  us 
rejoice  in  are  insurmountable  to  them;  they 
cannot  endure  the  hardships  we  glory  in  over- 
coming. They  have  no  "get  up  and  go"  to  them. 
If  now  with  such  a  weakened  nervous  condition 
they  attempt  overwork  or  excessive  exertion  of 
any  kind,  or  if  they  take  to  dissipation,  or  if  they 
have  been  grievously  injured,  or  a  sudden  fright 
or  shock  has  seized  upon  them,  or  if  they  have 
come  down  with  some  serious  disease  from  which 
they  have  recovered  perhaps  only  in  part,  then 

156 


MATURITY 

their  nervous  system  gives  out  entirely  and  they 
become  sufferers  from  nervous  prostration. 

These  poor  folk,  who  are  greatly  to  be  sympa- 
thized with,  as  greatly  as  if  they  had  some  profound 
organic  disease,  have  headaches,  especially  in  the 
back  of  the  head  and  neck;  backache;  they  have 
fatigue  dyspepsia  (of  which  more  presently)  and 
are  emotionally  very  irritable.  Things  that  most 
of  us  would  laugh  at  will  at  the  moment  send 
them  "up  in  the  air."  Neurasthenia  is  a  very 
chronic  trouble;  the  sufferers  are  sometimes  as 
well  up  to  par  as  the  rest  of  is;  and  then  again 
they  are  'way  down  in  the  dumps.  Before  forty 
the  ailment  can  always  be  recovered  from;  after 
twoscore  not  so  easily. 

The  Weir  Mitchell  cure  is  the  best  for  many 
of  the  far-advanced  cases — for  many  others  what 
might  be  called  the  "get-up-and-hustle  cure" 
is  appropriate.  Spinal  douches  at  bedtime  are 
excellent  and  induce  sleep.  Baths,  massage, 
electricity,  exercise  in  the  open,  are  all  needful 
measures.  At  least  six  tumblers  of  water  should  be 
drunk  during  the  day.  The  emunctories  must  be 
strictly  attended  to,  and  the  diet  must  be  light 
and  easily  digested.  Medicines  have  no  place 
whatever  in  the  treatment  of  such  patients.  Pro- 
miscuous tonics  and  "pick-me-ups,"  especially 
alcoholic,  have  induced  many  a  case  of  neurasthenia. 

A  normal  nervous  system  is  indeed  funda- 
mentally essential  to  right  mental  and  physical 
living.  No  harder  problem  perhaps  presents  itself 
to  medical  practice  than  the  normalizing  of  a 
below-par  nervous  system.  In  such  cases  it  is 
for  the  sympathetic  physician  to  direct  the  cam- 

157 


WHY  DIE  SO  YOUNG? 

paign;  but  the  actual  fighting  must  be  done  by- 
team  work,  the  doctor,  the  nurse,  and  the  patient 
all  pulling  loyally  together.  The  chief  difficulty 
is  that  the  patient's  will  power  has  become  sub- 
verted. In  another  place  I  have  observed,  regard- 
ing the  Three  Fates,  that  we  moderns  are  not 
content  that  finality  shall  lie  altogether  in  their 
hands.  We  realize  that  humankind  is  endowed 
also  with  that  most  momentous  of  all  gifts,  the 
noble  will,  by  which  we  become  coefficient  at  least 
in  the  working  out  of  our  own  individual  destinies. 
It  is  in  no  person's  power  to  change  his  heredity, 
should  this  have  been  such  an  unfortunate  one. 
And  yet  it  is  abundantly  in  medical  experience  that 
enormous  things  can  be  done  in  the  way  of  nulli- 
fying an  untoward  heredity,  such  as  the  shoddy 
nervous  system  all  too  often  is.  The  difficulties 
attending  a  vicious  environment  are  still  easier 
to  overcome;  most  of  us  can  get  away  from  any 
vicinity  or  condition  that  is  not  good  for  us  to 
be  in.  And  wonders  are  done  in  medical  science 
in  the  rectification  of  bad  functioning.  The  most 
difficult  task  of  all  is  the  normalizing  of  a  perverse, 
a  perturbed  human  will;  and  such  unruliness 
underlies  many  cases  of  neurasthenia.  Yet  by 
education,  training,  good  management,  with  some 
assimilation  of  the  spirit  of  religion  (not  of  the 
letter  which  killeth),  the  will  can  certainly  be 
restored  to  its  rightful  ownership.  Therein  lies 
the  cure  of  neurasthenia. 

FATIGUE   DYSPEPSIA 

Most  "psychasthenics"  suffer  thus.     Such  dys- 
peptics are  in  the  main  of  two  sorts;  sedentary  peo- 

158 


MATURITY 

pie  or  workers  rather  intellectual  than  manual ;  and 
those  who  are  not  hard  workers  of  any  kind,  but 
who,  being  affluent  and  therefore  relieved  of  any 
necessity  for  active  effort,  are  free  livers,  and  also, 
either  from  inheritance  or  acquisition,  worriers. 
Sooner  or  later  the  general  nutrition  of  these 
patients  begins  to  decrease,  their  appetite  becomes 
capricious,  they  lose  weight,  they  lose  sleep,  or 
their  sleep  is  broken  and  dream-disturbed;  they 
have  a  constant  sense  of  physical  fatigue  (as  we 
would  say,  they  have  "that  tired  feeling");  their 
memory  plays  tricks  on  them;  they  become 
irritable,  introspective,  lacking  in  self-mastery; 
are  dismayed  in  the  face  of  the  least  discomfiture, 
become  ignobly  cautious,  of  uncertain  courage, 
pessimistic,  firmly  convinced  in  only  one  respect, 
as  was  Hamlet  (that  typical  neurasthenic),  that 
both  the  world  and  the  times  are  out  of  joint. 
In  short,  they  have  become  neurasthenic  (deprived 
of  nervous  strength),  in  which  condition  they  are 
unable  to  do  concentrated  work,  either  mental 
or  manual,  and  life  becomes  for  them  a  veritable 
burden. 

To  this  fatigue  dyspepsia,  then,  are  prone 
either  those  who  have  called  upon  a  normal  nervous 
system  for  efforts  beyond  its  limitations,  or  those 
born  with  a  shoddy  nervous  system.  The  end  is 
the  same  in  both  instances — a  breakdown,  more 
or  less  complete,  of  nervous  stability,  the  break 
falling  for  the  most  part  on  the  digestive  apparatus. 
And  the  sufferer,  come  to  this  pass,  gets  so  obsessed 
with  the  increasing  evidence  of  his  failing  health 
that  he  is  unfit  for  any  successful  participation 
in  life's  duties  and  responsibilities;    subordinates 

159 


WHY  DIE  SO  YOUNG? 

all  other  considerations  to  anxieties  about  his 
seemingly  desperate  bad  health;  fears  cancer  or 
some  other  dreadul  explanation  of  his  condition, 
and  is  reduced  to  the  inglorious  status  of  the 
hypochondriac.  In  fiction  one  finds  this  type 
wonderfully  well  portrayed  in  the  earlier  chapters 
of  David  Harum.  The  remedies  are  dietetic, 
medicinal,  and  disciplinary.  Among  the  latter 
are  bathing  on  rising,  and  thorough  toweling; 
after  which  a  few  simple  exercises  such  as  will 
make  supple  the  voluntary  muscles  and  provide 
for  the  thorough  expansion  of  the  chest.  The 
day's  work  should  be  so  ordered  that  no  undue 
demand  is  put  on  the  energies,  mental  or  physical. 
It  is  imperative  that  no  work  of  any  kind  be  done 
after  the  evening  meal — some  kind  of  game  should 
be  played  instead.  There  should  be  eight  hours' 
sleep  in  the  twenty -four,  and  one  day  once  a  month 
in  bed.  Holidays  are  essential,  week-ends,  and 
once  a  year  a  long  vacation  away  from  the  usual 
routine  of  business  or  professional  work. 

HYSTERIA 

Hysteria  is  suffered  mainly  by  women,  sometimes 
by  children,  occasionally  by  males.  The  ailment 
is  characterized  by  lack  of  control  over  emotions 
and  acts.  To  vary  my  expression  regarding 
men  of  unstable  wills,  they  are  not  kings  of  all 
that  is  under  their  own  hats,  one  may  with 
equal  truth  say  of  hysterical  women  that  they 
are  not  queens  of  all  that  is  under  their  own 
bonnets. 

The    principal    causes    of    hysteria    are    poor 

160 


MATURITY 

heredity;  the  having  at  one  time  received  a  severe 
physical  blow,  or  a  profound  mental  or  moral 
shock;  the  indiscriminate  use  without  the  advice 
of  a  wise  physician  of  drugs  and  of  medicines 
which  contain  a  considerable  alcohol  content; 
acute  and  chronic  diseases  attended  by  much 
pain  and  exhaustion;  chronic  inattention  to  the 
emunctories;   and  errors  in  education. 

It  is  not  for  me,  in  this  place,  to  dilate  on  what 
is  to-day  the  most  prolific  cause  of  hysteria  in 
women.  But  in  mercy  to  womankind  (not  to 
say,  in  justice  to  us  all)  it  is  my  positive  duty  to 
allude,  at  least,  to  the  many  abnormal  notions 
prevailing  nowadays,  notions  political,  social,  and 
economic,  such  as,  if  they  are  going  to  prevail  and 
to  endure,  will  work  great  woe  to  our  civilization 
and  will  be  most  destructive  of  the  feminine  physi- 
cal, emotional,  and  mental  well-being. 

Imitation  hysteria  is  a  well  recognized  phenome- 
non. Many  people  domiciled  or  gathered  together 
in  boarding  schools,  prisons,  homes,  and  barracks 
may,  through  the  force  of  suggestion,  come  to  be 
affected  by  the  example  of  a  single  case  of  hysteria. 
Thus  do  many  become  victims  of  imitation  chorea 
or  St.  Vitus's  dance,  though  they  have  no  physical 
or  organic  abnormality  to  account  for  the  condition. 
And  hysterical  patients  in  hospitals  may  very 
closely  mimic  all  the  physical  and  other  symptoms 
of  patients  in  the  same  ward,  until  the  hysterics 
would  actually  appear  to  be  suffering  from  the 
afflictions  they  have  come  in  contact  with. 

The  symptoms  of  hysteria  are  paroxysmal  or  inter- 
paroxysmal;   the  latter  appearing  between  attacks. 

The  paroxysmal   symptoms   are   convulsive   in 

161 


WHY  DIE  SO  YOUNG? 

character,  and  are  preceded  generally  by  an  in- 
tense circumscribed  pain  in  the  head — the  imagi- 
nary tight  band  which  has  been  called  the  Helmet 
of  Minerva;  and  by  the  sensation  as  of  a  ball  rising 
in  the  throat  (the  globus  hystericus);  or  great 
pain  in  and  about  the  female  organs  of  generation. 
The  ancient  physicians,  Hippocrates  and  others, 
considered  the  last  named  the  chief  reason  for  this 
malady,  and  so  named  the  disease  hysteria  from 
the  Greek  word  meaning  "the  womb." 

The  hysterical  paroxysm  may  simulate  the 
epileptic  fit,  although  the  hysterical  woman  will 
not  bite  her  tongue  or  fall  so  as  to  hurt  herself. 
She  is  likely,  in  falling,  to  assume  a  graceful  attitude 
and  will  murmur,  "Where  am  I?"  in  melodramatic 
tones,  and  so  on.  All  sorts  of  erratic  movements 
are  made.  And  various  passionate  manifestations, 
as  of  anger  or  fright,  are  evidenced.  In  many 
cases  there  is  downright  delirium. 

The  interparoxysmal  symptoms  may  be  sensory 
or  motor  or  psychic.  The  psychic  are  either 
localized  anaesthesia  (pins  stuck  way  into  the 
skin  are  not  felt)  or  hyperesthesia  (excessive 
sensation);  or  paresthesia  (numbness  or  tingling 
or  a  sensation  as  of  ants  crawling).  The  motor 
symptoms  are  of  paralysis,  contractions  of  joints, 
tremors,  and  inco-ordinations.  Even  fractures  and 
dislocations  have  been  imitated  to  the  point  of 
creating  deception.  The  psychic  (that  is,  the 
mental)  symptoms  vary  from  mere  oddity  of 
thought  to  downright  insanity. 

The  treatment  requires  the  removal,  if  possible, 
of  the  agencies  which  have  brought  on  the  hysteria, 
the  services  of  a  wise  and  determined  doctor,  an 

162 


MATURITY 

efficient  nurse,  the  use  mainly  of  physiological 
means  of  cure  (baths,  massage,  electricity,  diet), 
and  above  all  isolation  from  oversympathetic 
relatives  and  friends.  The  Weir  Mitchell  rest 
cure  works  wonders  in  many  cases.  In  most  others 
simply  leading  the  hygienic  lif  e  will  achieve  the  cure. 

THE  EMOTIONS 

Most  people,  I  am  sure,  have  no  idea  of  the 
extent  to  which  our  emotions  are  "mirrored  in  the 
flesh." 

"I  remember,"  wrote  Oliver  Wendell  Holmes, 
"a  young  wife  who  had  to  part  with  her  husband 
for  a  time.  She  did  not  write  a  mournful  psean. 
Indeed,  she  was  a  silent  person,  and  hardly  said  a 
word  about  it.  But  she  quietly  turned  to  a  deep 
orange  color  with  jaundice."  If  that  young  wife 
had  just  gone  off  somewhere  by  herself  and  had 
had  a  good,  out-and-out  convulsive  cry — an  in- 
dividual electric  storm,  with  plenty  of  raindrops 
out  of  those  lachrymal  ducts  of  hers — her  emotions 
would  have  been  relieved,  and  she  would  probably 
not  have  had  that  jaundice. 

Then  there  is  the  fine  fear  of  which  Kipling 
wrote,  the  great  cowardice  which  must  be  felt  to  be 
appreciated,  the  quivering  dread  of  something  you 
cannot  see,  a  fear  that  dries  the  inside  of  the 
mouth  and  half  the  throat,  that  makes  you  sweat 
on  the  palms  of  the  hands,  and  gulp.  Nor  need 
one-half  humankind — the  lesser  half — be  reminded 
here  of  those  sensations  experienced  when,  Cu- 
pid having  shot  straight,  one  had  felt,  like  the  Hi- 
bernian, about    to    address    his    soul   mate,  "all 

163 


WHY  DIE  SO  YOUNG? 

of  a-thrimble."  It  is  the  physician's  everyday 
experience  to  see  terror  of  fatal  disease  raise  a 
normal  pulse  of  72  to  beyond  120 — all  of  which 
pitiable  and  excess  palpitation  subsides  with  the 
assurance  that  no  such  disease  is  suffered.  Thus 
have  the  emotions  ever  been  mirrored  in  the 
flesh.  But  now  the  scientist,  armed  with  his 
Rbntgen  rays,  demonstrates  unquestionably  to 
the  eye  the  very  fact — in  laboratory  experiments 
with  animals,  at  any  rate.  By  such  means  has 
paralysis  of  the  muscular  movements  of  the  in- 
testines been  observed — while  Professor  Cannon 
of  Harvard  has  shown  rage,  fright,  and  anxiety 
in  the  very  act  of  abolishing  the  movements  of 
the  stomach  and  also  of  its  secretory  and  digestive 
functions.  The  reader  who  will  come  upon  Dr. 
Hack  Tuke's  book,  The  Influence  of  the  Mind  on 
the  Body,  will  learn  much  to  his  advantage  as  to 
such  phenomena. 

PHOBIAS 

The  emotion  of  fear  is  in  many  cases  "tempera- 
mental"— that  is,  no  matter  how  good  the  health 
is,  fear  is  an  emotion  peculiar  to  them;  in  other 
cases  neurasthenia  and  fear  are  associated.  Fear 
is  in  most  cases  a  natural  result  of  lessened  personal 
force;  it  may  amount  only  to  a  general  and  constant 
feeling  of  uneasiness  or  anxiety,  or  there  may  be 
occasional  spontaneous  attacks  of  fear. 

The  most  frequent  form  of  fear  is  probably 
agrophobia,  in  which  the  victims,  the  moment 
they  come  into  an  open  space — literally  fear  of 
the  marketplace — are  oppressed  by  an  exaggerated 
feeling  of  anxiety;   they  seem  frightened  to  death, 

164 


MATURITY 

begin  to  tremble  all  over,  and  complain  of  faintness, 
a  smothered  feeling,  and  heart  palpitation.  They 
are  then  likely  to  break  into  profuse  palpitation 
and  to  declare  that  they  feel  as  if  chained  to  the 
ground  and  that  they  cannot  move  a  step.  It  is 
remarkable  that  the  sufferer  is  likely  to  be  able, 
without  trepidation,  to  cross  the  open  space  when 
accompanied  by  some  one,  even  a  little  child,  or 
if  he  carry  a  stick.  The  origin  of  this  phenomenon 
has  been  explained  in  this  way:  Our  primordial 
ancestors  were  arboreal.  From  the  treetops  they 
could  without  fear  of  reprisal  pelt  their  foes  in 
the  jungles  below  with  cocoanuts  and  the  like. 
But  when  they  ventured  on  the  open  spaces 
below,  the  swifter  and  more  powerful  jaguar, 
lion,  and  other  felines  could  "get  them  if  they 
didn't  watch  out."  People  who  fear  society,  who 
blush  and  are  exceedingly  nervous  when  spoken  to, 
may  be  called  anthrophobics;  very  many  youths  are 
gynephobics.  Then  there  are  those  who  have  the 
fear  that  things  will  fall  upon  them  from  on  high 
(batophobia) ;  and  those  afraid  of  everything  and 
everyone  (pantaphobia).  The  fear  that  here  con- 
cerns us  most  is  pathophobia — the  fear  of  disease. 
The  best  way  to  dissipate  this  fear  is  to  get 
thoroughly  examined  and  to  find  out  definitely  if 
there  is  any  occasion  or  no  occasion  to  be  dis- 
turbed. This  subject  of  fears  is  many-sided,  and 
we  must  take  it  as  seriously  and  as  sympathetically 
as  we  would  any  material  illness. 

HOW   TO   REST 

One  reason  why  people  suffer  nervous  prostration 
is  that  they  are  unacquainted  with  the  science  and 

12  165 


WHY  DIE  SO  YOUNG? 

art  of  resting,  than  which  nothing  should  be  more 
elementary — as  elementary  as  eating,  which  latter, 
however,  the  most  of  us  do  not  to-day  understand. 

Prof.  William  James  (that  philosopher  who  wrote 
like  a  novelist,  whereas  his  brother  Henry,  the 
novelist,  wrote  like  a  philosopher)  had  a  class  of 
tense  American  women  to  whom  he  was  teaching 
practical  psychology.  They  were  just  one  bunch 
of  human  strenuosity  (there  is  nothing  more 
potential,  either  for  better  or  for  worse,  in  the 
cosmos),  and  he  was  explaining  to  them  how  to 
relax.  Thereupon  that  composite  feminine  electric 
battery  immediately  applied  itself,  at  the  utmost 
high  tension,  to  the  task — of  relaxing. 

I  have  just  read  the  following  in  that  wonderful 
book  of  Henry  Drummond's,  The  Greatest  Thing  in 
the  World: 

I  heard  the  other  morning  a  sermon  by  a  distinguished 
preacher  upon  "Rest."  It  was  full  of  beautiful  thoughts;  but 
when  I  came  to  ask  myself,  "How  does  he  say  I  can  rest?" 
there  was  no  answer.  The  sermon  was  sincerely  meant  to  be 
practical,  yet  it  contained  no  experience  that  seemed  to  me 
to  be  tangible,  nor  any  advice  which  could  help  me  to  find 
the  thing  itself  as  I  went  about  the  world  that  afternoon.  Yet 
this  omission  of  the  only  important  problem  was  not  the  fault 
of  the  preacher.  The  whole  popular  religion  is  in  the  twilight 
here.  And  when  pressed  for  really  working  specifics,  for  the 
experiences  with  which  it  deals,  it  falters  and  seems  to  lose 
itself  in  mist. 

Of  course  Drummond  was  writing  about  the 
spiritual  aspect  of  life.  But  in  its  physical  aspect 
the  difficulty  is  about  the  same.  Most  people  do 
not  know  how  to  rest. 

Dr.  Mary  Sutton  Macy  has  had  considerable 
service — her  patients  all  woman — in  a  metropolitan 

166 


MATURITY 

neurological  clinic.  She  has  found  that  if  those 
patients  are  to  be  cured  they  have  first  got  to  be 
rested,  mentally  and  physically,  in  order  that  the 
physiological  balance  be  restored.  Medicines  might 
meanwhile  relieve  symptoms,  but  drugs  are  not 
expected  in  most  cases  to  effect  the  cure,  which 
can  come  about  only  through  giving  nature  a 
chance  to  recreate  a  healthy  organism.  Experience 
taught  Doctor  Macy  that  merely  to  send  those 
patients  home,  with  orders  to  rest  for  a  week,  and 
then  return  for  treatment,  would  not  do;  they 
had  to  be  trained  in  the  science  and  art  of  resting. 
She  undertook  to  instruct  personally,  and  with 
actual  demonstration,  those  nervous  women.  Far 
best  of  all,  she  taught  the  most  of  them  how  to 
get  well  without  drugs — not  all,  because  in  some 
cases  of  organic  disease  medication  is  "indicated." 
The  patient  had  to  report  three  times  a  week; 
during  every  visit  she  was  directed  how  to  fel- 
low this  instruction  at  home  daily  and  frequently 
for  from  ten-minute  to  half-hour  stretches.  Each 
woman's  progress  was  noted  from  visit  to  visit, 
and  the  instructions  given  her  were  amplified  and 
continued  until  she  knew  how  to  relax,  completely 
and  immediately,  from  any  position.  She  was 
made  to  understand  that  her  ability  thus  to  relax 
enabled  her  to  acquire  in  a  few  minutes  an  amount 
of  rest  equivalent  to  that  ordinarily  attained — or 
unattained — in  several  hours'  "lying  down,"  and 
that,  once  having  become  adept,  a  night's  sleep  in  a 
relaxed  manner  can  give  a  remarkable  amount  of 
restorative  vitality. 

Here  is  a  detail  of  Doctor  Macy's  procedure: 
She  has  her  patient  lie  down  comfortably  and, 

167 


WHY  DIE  SO  YOUNG? 

closing  her  eyes,  give  her  thoughts  to  relaxing  all 
her  arm  and  leg  muscles,  allowing  her  extremities 
to  lie  as  sodden,  heavy,  and  inert  as  dead  weights 
or  water-soaked  logs;  in  order  to  test  the  relaxation 
and  to  demonstrate  to  the  patient  its  success  or 
failure,  she  raises  an  arm  by  grasping  the  wrist, 
or  a  leg  by  the  ankle,  and  suddenly  lets  it  go; 
the  completely  relaxed  limb  will  instantly  fall 
limp;  the  least  enervation  is  shown  by  a  hesitation 
in  the  fall  of  the  limb  or  by  a  slightly  continued 
rise  after  cessation  of  the  motive  power  as  applied 
by  the  physician.  This  procedure  has  been  found 
beneficial  in  several  neurotic  manifestations. 

NEURITIS 

Neuritis,  either  local  or  general,  may  follow 
exposure  to  cold  or  overexertion,  a  blow  involving 
a  nerve,  or  it  may  occur  in  the  course  of  such 
diseases  as  typhoid  fever,  typhus,  scarlet  fever, 
measles,  malaria,  smallpox,  erysipelas,  grippe, 
diphtheria,  tuberculosis,  diabetes,  and  syphilis — the 
toxins,  in  the  blood,  of  those  diseases,  causing  the 
nerve  inflammation.  Alcoholism  is  frequently  to 
blame.  In  some  instances  it  may  come  on  quite 
spontaneously,  all  of  a  sudden  and  without  dis- 
coverable cause — and  quite  like  any  acute  infectious 
fever — chill,  headache,  loss  of  appetite,  pains  in 
the  back  or  joints  or  limbs,  so  that  one  thinks  of 
rheumatism.  There  is  intense  pain  in  the  nerves, 
of  an  entire  limb,  perhaps — but  this  is  not  constant. 

There  are  certain  metallic  poisons  used  in  the 
trades  and  in  other  ways  that  may  cause  neuritis. 
The  trouble  has,  for  instance,  followed  the  too 

168 


MATURITY 

prolonged  medicinal  use  of  Fowler's  solution  of 
arsenic.  Neuritis  occurred  in  the  case  of  a  young 
woman  who  had  been  accidentally  poisoned  by 
Rough-on-rats.  Neuritis  has  also  resulted  from  the 
accidental  or  intentional  contamination  of  food 
and  drink,  as  when  chrome  yellow  has  been  used 
to  color  cakes.  Also  from  beer  containing  arsenic 
or  from  the  sulphuric  acid  used  in  the  making  of 
glucose.  Lead  as  used  in  the  industries  is  a  more 
frequent  cause  of  neuritis  than  arsenic.  Mercury, 
phosphorus,  and  zinc  have  also  been  causative. 
Tea,  coffee,  and  tobacco  are  causes — though  rarely 
so;  also  coal  gas  and  coal-tar  drugs.  On  consulting 
the  physician  for  the  cure  of  neuritis  one  must 
tell  him  the  truth  as  to  the  cause,  in  order  that 
he  may  not  be  blamed  for  a  mistaken  diagnosis, 
in  order  that  the  neighbors  may  not  afterward 
learn  what  a  poor  doctor  he  was. 

And  now,  I  warrant,  I  shall  make  my  reader 
sit  up  and  take  notice.  Rushing  in  where  angels 
fear  to  tread,  I  am  going  to  dwell  on  alcoholic 
neuritis  in  women.  "Women  don't  drink,"  cer- 
tainly not  as  men  do.  And  yet  they  suffer  more 
than  men  do  from  what  is  really  a  form  of 
alcoholism. 

Women  assuredly  take,  in  the  form  of  "tonics," 
proprietary  medicines,  and  nostrums,  enormous 
quantities  of  alcohol.  The  content  of  the  latter 
in  a  remedy,  or  alleged  remedy,  must  now  by  law 
be  printed  on  labels.  And  one  finds  thus  an 
alcohol  content  almost  always  exceeding  15  per 
cent,  that  of  wines.  Before  the  establishment  of 
the  Federal  law  requiring  such  explicit  statement 
on   labels,    the   Massachusetts   Board   of     Health 

169 


WHY  DIE  SO  YOUNG? 

had  some  sixty  of  the  most  widely  advertised 
tonics  and  bitters  examined  for  their  alcohol 
strength  and  content;  and  this  latter  varied  from 
not  less  than  6  per  cent  to  more  than  49  per  cent. 
Thus  were  very  many  millions  of  dollars  spent 
for  drug  mixtures  containing,  everyone  of  them, 
more  alcohol  than  beer,  many  of  them  more  than 
wine,  and  several  of  them  as  much  as  or  more 
than  whisky.  And  the  doses  of  those  "harmless" 
remedies  were  labeled  as  from  a  teaspoonful  to  a 
wineglassful,  from  one  to  four  times  a  day,  "in- 
creased as  needed." 

How  can  the  condition  of  such  an  imbiber  differ 
from  that  of  the  frank  alcoholic — anyway,  from 
that  of  the  steady,  quiet  tippler,  who  is  never 
really  intoxicated,  but  who  in  the  course  of  the 
years  becomes  alcohol  saturated?  What  effects 
are  to  be  expected  other  than  such  as  result  from 
the  habitual  use  of  whisky  or  brandy  or  other 
frankly  spirituous  liquors — in  the  cases  of  women, 
who,  perhaps  unconsciously,  drink  spirits  thus 
disguised,  in  small  quantities,  over  long  periods, 
with,  at  the  same  time,  little  or  no  exercise  in  the 
open  air? 

Thus  comes  about  many  a  case  history  such  as 
this:  A  woman  has  become  run  down,  has  had 
for  long  periods  "that  tired  feeling";  malnutrition 
of  various  organs  has  been  causing  her  considerable 
suffering,  or  she  has  not  rightly  convalesced  from 
such  serious  malady  as  typhoid  fever,  rheumatism, 
or  malaria;  she  has  been  without  appetite,  has  not 
been  able  to  sleep  soundly;  she  has  been  taking 
little  or  no  exercise  in  the  open  air.  She  is  now 
attracted  to  some  advertised  remedy,  good  for  a 

170 


MATURITY 

long  train  of  printed  symptoms  and  untoward 
conditions — a  remedy  recommended,  perhaps,  by  a 
sister  sufferer  who  "has  been  helped  by  it."  Or 
a  regular  physician's  prescription  calling  for  alcohol 
as  an  ingredient,  has,  without  his  knowledge,  been 
renewed  many  times. 

In  the  course  of  months,  years,  perhaps,  there 
supervene  other  kinds  of  suffering:  odd  tingling 
in  the  feet  or  hands,  or  numbness,  or  a  sensation 
as  if  ants  were  crawling  over  the  skin.  Then  one 
or  both  forearms  or  legs  come  to  be  affected  in 
that  way  and  to  manifest  swelling  and  redness. 
Next  there  appear  real  neuralgias  in  those  parts — 
boring  or  burning  pain,  the  muscles  very  sore 
when  grasped,  the  sufferer  crying  out  when  touched 
or  moved  in  the  gentlest  way.  Now  comes  loss 
of  power  in  those  members,  and  the  paralysis, 
slight  at  first,  but  developing  to  wrist-drop  or 
the  "slapping  gait."  Ultimately  there  may  be 
most  distressing  contractions  of  the  extremities. 

All  this  is  pathetic  enough.  But  the  mental 
symptoms — well,  they  are  of  a  part  with  straight 
alcoholism.  A  natural  charming  disposition  has 
become  perverse.  There  are  delirium,  the  waking 
dream  state,  aberrations  of  the  senses,  especially 
of  the  vision.  The  most  extravagant  ideas  are 
expressed;  illusions,  hallucinations  are  exhibited, 
especially  toward  evening  and  at  night.  There  is, 
by  now,  practically  complete  loss  of  memory, 
inability  to  concentrate  the  attention,  utter  loss 
of  appreciation  of  time  and  place,  utter  irresponsi- 
bility. The  poor  sufferer,  now  a  frank  alcoholic, 
is  likely  to  conjure  up  all  sorts  of  impossible  events, 
to  make  the  loosest  accusations,  the  most  injurious 

171 


WHY  DIE  SO  YOUNG? 

reflections — baseless,  of  course.  She  will  narrate 
with  the  most  circumstantial  detail  how  she  has 
taken  long  trips  from  home,  with  purely  visionary 
descriptions  of  people  she  has  met — and  all  at  a 
time  when  she  has  been  bedridden.  There  is  the 
wildest  conceivable  romancing.  The  morale  is 
most  deplorably  lowered;  the  most  flagrantly  un- 
truthful and  hurtful  things  are  said.  How  much  of 
domestic  infelicity  is  here  connoted,  how  much  of 
neighborly  misunderstanding ! 

The  course  of  such  alcoholic  neuritis  is  generally 
favorable;  the  one  absolute  essential  in  restoration, 
however,  is  the  cutting  out,  inexorably,  of  every 
form  of  alcohol. 

CATARRH 

"Chronic  cold"  is  a  persistent  inflammation  of 
the  nose,  extending  to  the  throat  and  all  too  often 
through  the  Eustachian  tube  to  the  middle  ear, 
causing  eventual  deafness,  ringing  in  the  ears, 
dizziness,  and  much  other  distress.  It  is  generally 
the  result  of  uncured  acute  catarrh.  The  discharge 
from  the  nose  is  continuous;  the  handkerchief  is 
constantly  in  requisition.  There  is  always  a 
feeling  of  fullness  about  the  nose.  The  sufferer  is 
continually  catching  colds,  one  after  another; 
and  with  time  his  ailment  increases  in  severity. 
The  mucous  membranes  of  the  whole  upper 
respiratory  tract  become  thickened  and  obstructed, 
making  the  breathing  labored  and  difficult. 

This  characteristic  American  affliction,  besides 
following  uncured  acute  catarrh,  is  more  an  ac- 
companiment of  some  other  chronic  constitutional 
ailment  than  it  is  a  disease  in  itself;   upon  the 

172 


MATURITY 

cure  of  which  ailment  the  catarrh  will  get  well  of 
itself. 

The  simple  truth  about  catarrh  is  twofold: 
Every  acute  catarrh  must  be  cured  as  it  occurs, 
so  that  it  will  not  get  into  the  chronic  stage;  and 
only  the  experienced  doctor  can  manage  success- 
fully cases  of  chronic  catarrh.  He  must  find  out 
in  each  individual  the  essential,  underlying  condi- 
tions that  are  responsible  for  the  catarrh,  that 
are  keeping  it  up;  and  he  must  so  treat  the  patient 
that  those  underlying  conditions  will  be  removed. 
Then  he  has  to  attack  the  local  conditions  that 
are  peculiar  to  each  case.  He  has  to  use  caustic 
for  the  thickenings,  the  hypertrophies  (as  the 
doctor  calls  these  unhealthy  growths),  which  stop 
up  the  nose  and  make  life  so  uncomfortable  for 
the  sufferer  and  sometimes  also  for  his  family  and 
his  neighbors. 

TYPHOID   FEVER 

The  boys  recently  returned  to  us  had,  of  course, 
been  inoculated  against  typhoid  fever  by  their 
Uncle  Sam.  And  if  this  had  not  been  done  for  the 
embattled  millions  in  all  the  European  armies, 
and  if  like  preventive  measures  had  not  been 
instituted  against  the  other  camp  infections — 
typhus,  cholera,  the  plague,  malaria,  and  small- 
pox— the  war,  instead  of  lasting  several  years 
could  not  have  endured  beyond  several  months. 
For  the  vast  majority  of  the  soldiery  would  either 
have  been  dead  of  disease  or  have  been  too  sick 
to  fight.     That,  however,  is  another  story. 

Typhoid  fever  has  fourth  or  fifth  place  in  Ameri- 
can mortality  lists,  coming  only  after  tuberculosis, 

173 


WHY  DIE  SO  YOUNG? 

pneumonia,  cancer,  and  perhaps  heart  disease.  It 
takes  largely  among  us  the  place  of  cholera,  that 
"Asiatic  guest"  which  European  peoples  have 
from  time  immemorial  so  constantly  and  so  un- 
necessarily entertained.  Both  these  diseases  are 
"ingestion  infections"  contracted  in  absolutely 
no  other  way  than  by  swallowing  food  and  drink 
(the  latter  mostly  impure  water  and  milk)  contam- 
inated in  various  disgusting  ways,  with  either  the 
cholera  or  the  typhoid  bacillus.  Dirty  fingers 
take  the  center  of  the  stage  in  the  gruesome  drama 
which  so  often  ends  tragically. 

Scientifically  speaking,  nothing  can  be  simpler 
than  the  prevention  of  these  infections;  the 
application  of  the  prophylactic  principles  is,  how- 
ever, of  considerable  practical  difficulty,  by  reason 
solely  of  human  obstinacy  and  supineness.  For 
example,  there  is  the  cook,  Typhoid  Mary,  a 
carrier  of  the  typhoid  germ,  who,  although  she 
declared,  and  probably  correctly,  that  she  had 
never  had  the  disease,  had,  nevertheless,  in  those 
migrations  from  family  to  family  peculiar  to  her 
caste,  through  a  number  of  years,  disseminated 
the  infection  to  some  score  or  more  of  sufferers. 
There  have  indeed  been  typhoid  carriers  who 
have  had  the  disease  forty  years  previously,  and 
have  continued  through  all  that  time  being  a 
menace.  It  is  computed  that  one-fourth  of  the 
people  who  have  had  typhoid  are  carriers,  that, 
disease  or  no  disease,  one  in  every  one  thousand 
of  us  is  such  a  carrier,  a  typhoid-bacillus  distributor. 

Most  infections  are  self -limited ;  their  quarantin- 
ing period  is  fixed.  But  you  cannot  quarantine  a 
carrier  a  whole  lifetime,  any  more  than  you  can 

174 


MATURITY 

frame  an  indictment  against  a  whole  people.  The 
great  trouble  with  Typhoid  Mary  has  been  her 
perversity,  exceeding  that  characteristic  of  her 
most  temperamental  of  callings.  She  has  never 
conceded  herself  a  menace;  she  has  not  obeyed 
the  sanitary  directions  given  her  by  the  authorities; 
she  would  not  wash  and  disinfect  her  hands  as 
required;  she  would  not  change  her  occupation 
for  one  in  which  she  will  not  endanger  the  lives 
of  others;  under  an  assumed  name  she  emulated 
the  Wandering  Jew,  who  scattered  the  seeds  of 
cholera  in  his  path.  Typhoid  carriers  who  are 
amenable  to  reason,  humane,  conscientious,  care- 
ful, and  scrupulously  clean  need  endanger  nobody's 
existence. 

The  best  insurance  against  typhoid  is,  after  all, 
to  get  inoculated  against  the  disease,  as  all  sensible 
people  are  now  vaccinated  against  smallpox. 
Especially  is  this  well  to  do  when  there  are  typhoid 
epidemics  about;  and  for  commercial  travelers, 
motorists,  tourists,  and  vacationists  who  may, 
in  the  most  subterranean  ways,  contract  typhoid 
and  become  typhoid  carriers.  And  since  here  is  a 
disease  largely  of  early  manhood  and  womanhood, 
our  young  people  going  to  boarding  school  and 
colleges  should  certainly  submit  to  this  preventive 
measure  before  leaving  home.  Typhoid,  which 
in  other  wars  slew  several  fold  as  many  as  became 
Kanonenj utter,  was  practically  unknown  in  the  war 
just  ended,  by  reason  of  the  obligatory  anti- 
typhoid inoculations.  It  is  considered  that  this 
protection,  thus  afforded,  is  effective  for  at  least 
two  years;  the  immunization  may  indeed  be  for 
life.      When    the   inoculations    are    made    in    the 

175 


WHY  DIE  SO  YOUNG? 

afternoon  untoward  sensations  are  likely  to  have 
disappeared  by  the  following  noon.  A  series  of 
three  successive  inoculations  are  made  a  week 
apart.  Death  has  been  attributed  to  them;  but 
in  every  case  I  have  been  able  to  look  up  the 
death  has  been  found  by  the  authorities,  on  autopsy, 
to  have  been  due,  not  at  all  to  the  inoculations, 
but  to  some  disease  in  no  wise  related  to  or  affected 
by  this  wonderful  preventive  measure. 

MALARIA 

People  do  not  often  die  directly  of  malaria 
(except  perhaps  in  the  comparatively  rare  cases 
of  "pernicious  malaria");  but  this  disease  generally 
weakens  the  body  so  much  that  it  becomes  anaemic 
and  easily  predisposed  to  other  and  more  fatal 
diseases.  Here  is  a  most  unusually  miserable 
affection,  both  as  to  its  immediate  symptoms  and 
as  to  the  spirit-  and  energy-destroying  effect  (the 
chronic  malaria  cachexia)  it  often  has,  perhaps 
for  many  years.  It  is  perhaps  the  most  occasion- 
less  of  diseases,  because  it  comes  about  solely 
through  the  bite  of  the  Anopheles  mosquito. 
With  this  bite  that  insect  conveys  to  the  fresh 
victim  the  Plasmodium  malarias,  the  malaria  germ, 
which  has  been  abstracted  with  the  blood  of  a 
previous  and  an  active  sufferer.  This  mosquito 
bites  generally  only  after  sundown.  I  must  refer 
the  reader  to  his  health  department  or  to  the 
Bureau  of  Entomology  at  Washington  for  the 
necessary  and  adequate  information  for  the  eradi- 
cation of  that  insect  pest.  Suffice  it  to  say  here 
that  any  body  of  water,  indeed  no  more  than  an 
ounce,    that   has   been   stagnating   for   ten   days 

176 


MATURITY 

(the  birth  cycle  of  the  Anopheles)  is  a  potential 
malaria  granary.  Also,  drainage  and  filling  up 
of  wet  places  solid  are  the  surer  ways  of  mosquito 
elimination;  while  the  use  of  petroleum  oil  (semi- 
refined)  is  a  fair  temporary  expedient.  Oil  destroys 
the  larvae  by  plugging  up  their  breathing  apparatus. 
One  ounce  of  oil  will  cover  fifteen  square  feet  of 
water  surface  and  will  remain  effective  ten  days. 
The  wind  may  blow  this  oil  aside,  to  return  generally 
when  the  wind  changes;  and  though  eggs  may 
have  been  deposited  meanwhile,  the  returning 
oil  will  suffocate  the  new  larvae.  An  ordinary 
garden  sprinkler  may  be  used,  or  a  knapsack 
sprinkler  from  which  oil  may  be  projected  several 
yards  from  shore  or  from  a  boat.  All  malaria 
patients  should  be  cured  as  soon  as  possible,  so 
that  the  mosquito  cannot  abstract  the  germ  with 
its  bite  and  transfer  it  to  other  human  beings. 

VACCINATION 

The  main  smallpox  preventive  is  vaccination. 
This  may  be  done  in  time  of  epidemics  at  the 
second  or  third  month  of  babyhood.  All  persons 
should  be  vaccinated  at  least  at  seven-year  intervals, 
and  always  after  exposure  to  the  disease  or  during 
epidemics.  If  one  is  vaccinated  within  three  days 
after  exposure  to  a  case  he  need  not  worry  about 
contracting  it.  For  this  slight  operation  reliable, 
government-tested  calf  lymph  should  be  used. 
The  skin  of  the  arm  above  the  deltoid  muscle,  at 
its  insertion,  is  cleansed  by  means  of  soap  and 
water,  and  then  by  alcohol  (but  no  stronger  anti- 
septic, lest  the  virus  be  deprived  of  its  effect). 
Then   the   skin   is   scarified   deep   enough   to   let 

177 


WHY  DIE  SO  YOUNG? 

serum  exude,  but  no  blood;  a  sterile  needle  or 
lancet  is  used.  The  vaccine  point  is  rubbed  into 
the  wound  and  allowed  to  dry.  A  piece  of  sterile 
gauze  may  be  used  as  a  protective  dressing. 

There  are  people  even  nowadays  who  are  averse 
to  vaccination  against  smallpox.  They  wonder  if 
this  dreadful  infection  cannot  be  prevented  by  other 
means.  They  fear  that  vaccination  may  be  dan- 
gerous and  ask  if  it  is  needed  nowadays,  when 
there  is  so  little  smallpox.  Let  us  take  up  these 
considerations. 

1.  Before  Doctor  Jenner,  now  more  than  a 
century  ago,  put  vaccination  on,  and  showed  how 
to  put  smallpox  off,  the  map  of  civilization,  whole 
cities  were  decimated,  whole  towns  and  villages 
wiped  out  of  existence,  by  this  most  virulent 
pestilence.  Public  officials  divided  the  people 
into  those  who  have  had,  those  having,  those 
going  to  have  smallpox.  One  of  four  sufferers 
died;  of  the  survivors  many  were  blinded,  and  in 
Johnson's  and  his  Boswell's  day  every  other 
adult  was  pock-marked.  Nor  did  this  hideous 
infection  respect  royalty  any  more  than  it  did 
the  common  people.  Such  is  the  picture  before 
Jenner.  Look  now  at  the  after  picture.  Com- 
pulsory vaccination  has  done  this  for  Germany; 
during  long  periods  before  the  present  war  she 
had  not  had  a  single  death  among  her  sixty-odd 
million  of  people.  And  greater  New  York,  which 
has  been  having  an  inexorably  efficient  health 
department,  had  in  1913,  despite  its  fifty -seven 
varieties  of  immigrants,  just  one  smallpox  death. 
Tomes  of  statistics  are  to  the  same  effect.  Iso- 
lation, notification,  disinfection,  quarantine — yes, 

178 


MATURITY 

these  measures  help;  but  a  superabundance  of 
fateful  experience  has  shown  that  they  simply  will 
not  take  the  place  of  vaccination. 

2.  The  dangers  are  infinitesimal  by  comparison 
with  those  this  measure  shields  us  from.  All 
surgery  has  elements  of  danger;  so  has  a  pin 
prick  or  a  razor  scratch.  Walking  along  a  country 
road  these  "  devil- wagon "  days  is  much  more 
dangerous  than  vaccination.  Our  doctors  vacci- 
nated three  and  a  half  million  Filipinos,  not  all  of 
them  overcleanly,  without  a  single  death  or  any 
post-vaccinal  complication.  Practically  all  con- 
ceivable danger  comes  after  this  slight  operation, 
from  the  lack  of  proper  precautions.  Obey  your 
doctor  and  there  will  be  absolutely  no  danger. 

3.  There  is  so  little  smallpox  nowadays  because 
our  health  boards,  being  eternally  vigilant,  are 
constantly  demonstrating  the  efficiency  of  vacci- 
nation, especially  when  epidemics  threaten.  Be- 
sides, one  of  the  most  gruesome  facts  about  small- 
pox is  its  periodicity.  It  has  had  its  lessened 
prevalence  when  the  supply  of  susceptible  human 
material  was  exhausted;  then  it  has  thriven  anew 
with  the  coming  of  fresh  generations.  Thus,  from 
1893  to  1897  smallpox  killed  off  346,520  persons 
in  sixteen  countries — 275,000  in  Russia  alone; 
simply  because  vaccination  was  no  longer  deemed 
necessary.  Let  us,  then,  not  be  bold  against  an 
absent  danger;  nor  "despise  the  antidote  while 
one  has  no  painful  experience  of  the  bane." 

THE   BODY'S   SENTINELS 

If,  as  Dr.  Woods  Hutchinson  observes,  a  man 
is  known  by  the  teeth  that  he  keeps,  then  the 

179 


WHY  DIE  SO  YOUNG? 

most  of  us  are  quite  unfit  for  even  moderately 
high  society.  In  not  one  of  a  hundred  cases  is 
the  doctor  able  to  record  a  perfect,  nor  even  nearly 
perfect,  set  of  teeth.  Good  old  Sancbo  Panza 
observed  that  a  diamond  is  not  worth  so  much  as 
a  tooth.  We  all  read,  when  Colonel  Roosevelt 
died,  of  how  the  rheumatism,  of  which  during  his 
life  he  suffered  much,  originated  in  a  tooth  which 
had  been  ulcerated  twenty  years  before.  The 
care  of  the  teeth  we  have  already  considered.  In 
very  many  cases  dead  teeth  from  which  the  nerves 
have  been  removed,  the  roots  of  capped  teeth,  or 
decayed  teeth  and  diseased  gums,  are  in  reality 
infection  focuses  from  which  auto-intoxication, 
rheumatism,  goiter,  stomach  ulcer,  heart  and 
kidney  disease,  head  infections,  brain  abscesses, 
neuritis,  and  many  other  serious  inflammations 
have  been  traced  by  competent  physicians.  Among 
such  infection  centers  tooth  cavities  come  first 
in  the  order  of  danger;  next  diseased  tonsils, 
catarrhs  of  the  upper  air  passages,  ear  inflam- 
mations, inflamed  gall  bladders,  and  appendixes 
gone  wrong.  By  X-raying  the  teeth  any  infection 
focus  is  now  easily  detected. 

INFECTION   CENTERS 

Most  notable  studies  have  of  recent  years  been 
made  of  "weak  spots"  in  the  human  body;  of  the 
kinds  of  disease-engendering  germs  found  in  such 
susceptible  tissues;  of  the  ways  in  which  the 
infections  thus  arising  affect  the  rest  of  the  body; 
how  those  infections  are  likely  to  put  various 
organs,  quite  remote,  perhaps,  from  the  original 

180 


MATURITY 

infection  focus,  out  of  action,  or  to  break  them 
down  utterly.  Many  of  the  diseases  of  mature 
life  have  their  origin  in  this  fact  of  focal  infection. 

There  may  be  such  a  focus  in  a  child's  "running 
ear,"  in  and  around  tonsils  that  have  over  and 
over  again  been  inflamed,  in  a  nasal  or  throat 
catarrh,  among  diseased  teeth,  in  an  appendix 
that  has  from  time  to  time  given  trouble,  in  a 
gall  bladder  irritated  by  stones  or  which  has 
become  a  typhoid-fever  granary,  in  the  tops  of  a 
pair  of  lungs  not  expanding  as  well  as  they  might 
and  should,  in  the  pleura,  in  the  pancreas,  and  in 
literally  dozens  of  other  vulnerable  localities. 

There  may  be  more  than  one  infection  focus — 
the  primary  focus  and  secondary  ones,  the  infec- 
tious material  having  been  conveyed  from  the 
former  to  the  latter  by  way  of  the  blood  and 
lymph  channels.  And  then  those  secondary  centers 
may  occasion  others  with  prolonged  and  all  too 
often  serious  results.  And  all  kinds  of  germs  are 
found  in  those  foci,  such  as  produce  abscess, 
pneumonia,  tuberculosis,  diphtheria,  heart,  kidney, 
liver,  and  other  infections.  A  very  frequent  type 
of  focal  infection  is  rheumatism,  which  disease  we 
will  later  consider. 

And  some  of  the  specific  germs  found  in  those 
baneful  centers  will  be  found  mixed  with  the 
germs  of  other  diseases.  This  is  "mixed  infection," 
a  much  graver  condition  than  a  straight  out  and 
out  infection.  That  is  why,  for  instance,  some 
people  die  of  pneumonia,  no  matter  how  skillfully 
they  may  have  been  treated  and  nursed;  in  such 
cases  suppuration  germs  have  been  combined 
malignly  with  the  pneumococcus.    Mixed  infection 

13  181 


WHY  DIE  SO  YOUNG? 

is  what  makes  tuberculosis  the  fatal  malady 
consumption;  a  pure  out  and  out  tuberculosis  is 
rarely  fatal. 

Practically  every  case  of  pleurisy  that  is  not 
promptly  and  properly  healed  is  followed  by 
pulmonary  tuberculosis.  The  man  with  a  de- 
ranged pancreas  is  pretty  sure  to  develop  diabetes. 
A  boy  had  his  thumb  crushed  in  an  accident; 
pus  developed  in  the  wound;  ten  days  after  he 
suffered  rheumatism,  which  "went  to  the  heart." 
The  pus  from  that  boy's  wound  produced  rheu- 
matism in  a  guinea-pig.  A  girl  suffering  from 
chorea  (St.  Vitus's  dance)  had  been  treated  by 
medicines,  and  ineffectually,  for  weeks;  she  also 
had  an  infected  tonsil;  five  weeks  after  this  latter 
was  extirpated  she  was  cured  of  her  chorea.  An 
eminent  physician  writes  me: 

"Little  over  two  years  ago  I  was  very  ill — a 
septic  thrombus  of  dental  origin  in  my  right 
brain.  This  knocked  me  out  for  the  better  part 
of  a  year,  but  fortunately  resolution  occurred 
without  leaving  a  single  trace  of  the  lesion.    When 

I  explained  this  to and  called  his  attention  to 

the  fact  that  this  thrombus  (an  arterial  plug) 
had  given  me  the  choice  between  a  suppurating 
artery  and  an  apoplexy,  on  the  one  hand,  or  a 
brain  abscess,  on  the  other — and  that  I  declined 
both,  he  replied,  'Some  people  are  damned 
hard  to  please.' " 

These  are  very  scientific — that  is,  reliable — 
facts,  and  they  are  based  on  most  logical  premises. 
The  natural  conclusion  is  that  if  one  is  to  be 
cured  of  any  disease  arising  out  of  an  infection 
focus,  that  focus  has,  like  the  canker  in  the  fruit, 

182 


MATURITY 

to  be  sought  out  and,  if  possible,  got  rid  of,  by 
surgery  if  necessary,  as  the  first  step  to  any  sensible 
treatment.  That  is  why  all  people,  in  mature 
life,  anyway,  should  go  to  their  doctors  as  they 
go,  or  ought  to  go,  to  their  dentists,  at  least  once 
a  year  for  a  thorough  overhauling.  Only  thus  can 
the  doctor,  and  perhaps  also  the  surgeon  he  calls 
into  consultation,  learn  how  properly  to  remove 
any  disease  that  has  taken  hold  in  the  system. 

THE   PERFECT   HUMAN   BEING? 

Thus  it  is  that  medical  examiners  and  diagnosti- 
cians generally  become  skeptical  of  the  existence 
anywhere  on  this  mundane  sphere  of  a  perfect 
human  being.  Which  recalls  the  pleasantry  about 
the  clergyman  who  asked  at  Wednesday  evening 
prayer  meeting,  "Does  anyone  in  the  congregation 
know  of  a  perfect  human  being?"  WThereupon  a 
poor  little  woman  piped  up,  "I  know  all  about  a 
perfect  human  being.  But  she's  dead  now.  She 
was  my  husband's  first  wife." 

The  fact  is,  when  we  have  come  upon  anyone 
90  per  cent  physically  right,  we  have  met  a  speci- 
men above  the  average.  And  much  better  results 
could  be  recorded  if  people  would  undergo  the 
thorough  overhauling  I  have  advised  and  would 
have  any  weedy  growth  extracted  betimes  from 
that  most  precious  of  cosmic  soils,  the  human 
body.  By  thus  taking  thought  for  the  only  sentient 
machine  we  shall  during  this  life  possess,  we  may 
all  of  us  safely,  and  pleasantly,  attain  our  four- 
score at  least,  or  perhaps  our  century  mark. 

This  book  is  individualistic  in  its  trend.  But, 
183 


WHY  DIE  SO  YOUNG? 

just  as  no  truth  can  be  absolutely  isolated,  so 
can  no  one  among  us  exist  absolutely  independent 
of  the  rest  of  us  or  of  the  world  about  him.  And 
we  should  consider  here,  for  a  few  pages,  how 
the  human  unit's  well-being  is  related  to  the 
world's  work. 

One  of  the  weightiest  questions  of  our  time  is 
that  of  everyone's  adaptability  to  his  calling,  be 
it  that  of  banker  or  of  merchant,  of  bricklayer, 
iron  molder,  cobbler,  clerk.  And,  as  the  vast 
preponderance  of  our  labor  is  to-day  congregated 
in  large  corporations,  many  of  the  latter  have 
wisely  required  their  employees  to  demonstrate 
their  physical  fitness  before  they  go  on  their  jobs. 
And  such  corporations  have  (not  as  a  matter  of 
philanthropy,  but  strictly  as  a  business  proposition) 
required  their  men  to  be  periodically  re-examined 
while  they  are  working  for  their  respective  concerns. 

THE   INDUSTRIAL  SURGEON 

The  duties  of  that  twentieth-century  product, 
the  industrial  surgeon,  are  in  the  main:  1.  To 
make  physical  examinations  of  all  prospective 
employees  and  to  advise  corrective  measures. 
2.  To  treat  accidents  immediately  after  they  have 
occurred  and  to  give  subsequent  treatments.  3. 
To  make  examinations  and  to  give  advice  in  cases 
of  sickness.  4.  To  formulate  and  control  sanitation 
measures  throughout  the  works.  5.  To  promote 
health  education  among  employees. 

How  is  the  employer  advantaged?  The  best 
time  to  examine  a  man  is  before  he  is  hired.  This 
enables  the  manager  of  the  works  to  place  a  man 

184 


MATURITY 

at  the  kind  of  work  for  which  he  is  best  fitted 
physically.  Also  it  enables  the  doctor  to  advise 
the  employee  regarding  any  defects  that  he  may 
have  and  of  which  he  may  not  be  aware.  It 
gives  the  doctor  opportunity  to  enlist  the  man's 
co-operation  in  making  effort  to  overcome  his 
defects,  when  possible,  and  thus  increase  his 
physical  efficiency.  It  prevents  the  introduction 
into  the  factory  of  men  undesirable  because  of 
serious  defects.  It  prevents  contagious  diseases 
entering  the  factory  and  becoming  established 
there. 

How  does  all  this  affect  the  employee?  He  is 
informed  of  any  defects  the  doctor  finds  and  is 
helped  in  obtaining  relief.  He  is  not  given  work  to 
do  for  which  he  is  not  physically  fitted.  He  knows 
that  every  other  man  in  the  factory  has  had  a 
similar  examination  and  appreciates  the  fact  that 
he  is  safeguarded  from  contagious  diseases.  He 
feels  that  his  employer  is  taking  a  personal  interest 
in  his  condition  and  that  he  can  go  to  the  plant 
doctor  for  further  advice  at  any  time. 

Objection  has  been  made  to  the  physical  exami- 
nations of  employees  by  the  industrial  surgeon, 
on  the  ground  that  it  infringes  on  the  liberty  of 
the  individual.  The  United  States  government 
has,  however,  established  the  precedent,  in  ex- 
amining all  candidates  for  army,  navy,  and  civil- 
service  positions,  and  it  is  a  fair  and  good  precedent. 
It  would  seem  again  to  be  feared  that  information 
of  defects  in  certain  men  might  be  passed  from 
employer  to  employer,  thus  making  it  possible  to 
blacklist  a  man;  but  to  fear  this  is  to  fail  in  the 
realization  that  such  information  is  of  a  professional 

185 


WHY  DIE  SO  YOUNG? 

nature  and  secrets  thus  obtained  are  as  carefully 
guarded  as  in  a  family  doctor's  office. 

The  industrial  surgeon's  examination  should  be 
as  thorough  as  that  required  for  a  life-insurance 
policy,  because  in  many  departments  of  factories 
the  work  is  of  a  hazardous  nature.  The  physical 
examination  would  prevent  a  defective  man  from 
being  put  to  work  in  a  department  where  hazardous 
work  is  done.  This  benefits  the  employee  because 
it  enables  him  to  secure  adequate  protection  at  the 
most  reasonable  rates.  Rejections,  states  Dr.  John 
F.  Curran  of  Worcester,  Massachusetts,  are  few — 
contrary  to  the  general  opinion.  Statistics  show 
3  per  cent.  The  surgeons  actually  make  no  rejec- 
tions. They  merely  note  the  man's  defects, 
classify  him  as  an  A,  B,  C,  or  D  risk,  and  refer 
him  to  the  employment  department,  which  accepts 
or  rejects  him  according  to  his  probable  value. 
Sometimes  the  employment  manager  finds  a  man 
too  old  or  physically  unfit  for  the  work  for  which 
he  applies;  but  instead  of  rejecting  him  arbitrarily, 
work  is  found  for  him  suitable  to  his  age  and 
physical  condition.  A  man  is  definitely  rejected 
who  is  blind  in  one  eye,  because  work  on  grinding 
wheels,  for  instance,  is  very  hazardous  to  those 
precious  organs,  even  when  goggles  are  worn — 
total  blindness  being  a  possibility,  perhaps  indeed 
a  probability.  All  cases  of  contagious  disease, 
including  tuberculosis,  debar  a  man  from  em- 
ployment. It  is  a  fact/  that  the  consumptive 
workman  will  endanger  his  fellow  workmen  more 
than  he  will  his  own  family  at  home.  Hernia  is 
the  bane  of  industrial  surgery,  and  men  with 
second-degree  rupture  are  not  recommended   for 

186 


MATURITY 

employment.  Workmen  of  the  Latin  and  Asiatic 
races  are  most  prone  to  hernia  because  their 
diet  "in  the  old  country"  has  included  very  little 
muscle-building  food.  Hernias  are  curable  by 
operation.  All  cases  of  heart  disease  with  "dis- 
turbed compensation"  (as  evidenced  by  extreme 
shortness  of  breath,  swelling  of  the  extremities  and 
palpitation)  are  rejected.  Varicose  ulcer  is  a 
menace  because  a  man  working  on  his  feet  will 
grow  worse  with  it;  only  in  a  reclining  position 
can  one  be  cured  of  such  a  leg  ulcer.  Cases  of 
marked  high  blood  pressure  are  rejected  because 
certain  kinds  of  work  might  increase  the  already 
high  tension  and  lead  to  apoplexy.  All  men 
presenting  these  defects  are  re-examined  every 
three  months,  and  engaged,  should  their  improved 
condition  warrant. 

Almost  no  man  is  thrown  out  of  any  corporation 
unless  he  is  absolutely  unfit  for  any  work  at  all. 
But  the  man  with  a  heart  leakage  has  that  fact 
determined  to  begin  with;  and  then,  instead  of 
being  sent  up  to  clean  windows  forty  stories  above 
the  street,  he  is  given  some  light  and  unexciting 
occupation  on  the  safe  bosom  of  Mother  Earth. 
Has  a  man  a  tendency  to  tuberculosis?  It  is 
more  fortunate  for  him  than  it  is  for  his  employer 
that  the  fact  has  been  ascertained  at  the  beginning. 
Then  instead  of  being  put  to  work  in  a  close  and 
dusty  shop  he  could  be  sent  out  to  canvass  or 
to  do  some  ether  outdoor  work,  or  be  even  put 
into  a  sanatorium  maintained  by  his  employer 
company.  By  such  rational  measures  has  business 
efficiency  been  enormously  increased,  to  the  great 
good  of  the  unfit  worker  (with  whom  we  are  here 

187 


WHY  DIE  SO  YOUNG? 

chiefly  concerned),  of  the  business  enterpriser,  and 
of  the  country  in  general. 

FATIGUE  AND    EFFICIENCY 

The  conservation  of  the  human  machine  has 
many  aspects.  Consider,  for  instance,  the  relation 
of  fatigue  to  efficiency.  The  latter  decreases  as 
fatigue  begins,  and  it  ends  far  short  of  exhaustion. 
Enterprisers  find  that  it  pays  to  alternate  judi- 
ciously work  and  rest;  to  eliminate  all  unnecessary 
motions;  to  guard  the  worker  against  molestation 
or  interruption;  to  have  light,  ventilation,  and  other 
sanitary  factors  agreeable;  and  to  take  counsel 
of  the  physician,  the  sanitarian,  and  the  psycholo- 
gist. There  is,  in  the  worker's  tired  brain,  nerves, 
and  muscles,  danger  not  only  to  himself,  but  to 
others.  The  number  of  accidents  increases  pro- 
gressively during  the  morning,  as  fatigue  comes 
on;  drops  after  the  noon  recess;  rises  hour  after 
hour  until  the  end  of  the  working  day.  The 
same  obtains  with  brain  work  as  with  muscle 
work;  there  is  in  science  really  no  difference. 
Bank  managers  long  ago  recognized  the  relation 
of  fatigue  to  efficiency,  and  have  therefore  closed 
their  tellers'  windows  at  three;  less  expensive 
this  than  the  mistakes  of  tired  employees.  How 
often  has  the  overwrought  dispatcher  sent  trains 
into  collision!  Fatigue,  nerve  tension,  and  worry 
are  perverse  and  uneconomic  factors. 

ALCOHOL  AND   EFFICIENCY 

Those  who  are  charged  with  the  conduct  of 
great  commercial  and  industrial  enterprises  must 

188 


MATURITY 

seriously  consider  the  degenerating  part  which 
alcohol  plays.  For  example,  managers  of  railways 
are  insisting  on  total  abstinence.  Intemperate 
railway  employees  have  been  found  unable  to 
recognize  green  and  red,  the  two  colors  most  used 
in  operating  trains.  So  hidden  might  this  fault 
in  vision  be  that  only  an  accident,  with  loss  of 
human  life,  would  reveal  the  engineer's  inability 
to  recognize  signals.  Such  "toxic  amblyopia" 
(which  comes  also  from  the  excessive  use  of  tobacco) 
varies  in  degree  from  slight  dimness  of  vision, 
through  the  inability  to  recognize  colors,  to  seeing 
everything  gray — and  then  to  total  blindness.  Those 
who  are  every  day  responsible  for  the  lives  of 
thousands  of  passengers  would  themselves  be  most 
perverse  were  they  to  take  the  risk  of  engaging 
such  men.  , 

Among  138  cases  of  "visual  defects,"  64  in- 
dividuals were  found  to  be  hard  drinkers;  45 
used  both  alcohol  and  tobacco  to  excess;  and 
23  were  inveterate  smokers — leaving  but  6  cases 
to  diabetes  and  other  causes.  It  is  the  nerve 
cell  (with  its  fibers)  which  is  the  physical  basis 
of  all  mental  processes — memory,  will,  judgment, 
divine  reason;  and  it  is  this  cell  and  its  fibers 
(the  telegraph  wires  transmitting  the  cell's  signals 
to  all  the  tissues,  organs,  and  muscles  in  the  body) 
which  are  the  most  affected  of  all  the  bodily  parts 
by  alcoholism  and  especially  by  the  drinking  of 
fusel  oil,  or  wood-alcohol  whisky.  Thus  the  nerve 
cell,  progressively  shrinking,  becomes  in  time  a 
mere  shell,  with  degenerate  debris,  in  the  place  of 
a  once  virile  servant  of  the  body  and  soul. 

No  one  doubts  that  alcohol,  in  large  quantities, 

189 


WHY  DIE  SO  YOUNG? 

is  a  poison.  In  another  place  we  shall  consider 
its  effects  on  the  so-called  moderate  drinker.  For 
many,  also,  alcohol,  even  in  small  quantities,  may 
be  harmful;  such  is  the  opinion  of  Prof.  Irving 
Fisher  of  Yale.  Benjamin  Franklin  in  his  Auto- 
biography gives  his  own  experience  (an  individual 
one,  which  in  science  must  perforce  have  limited 
value)  that  in  his  printer's  trade  he,  a  total  ab- 
stainer, was  stronger,  clearer-headed  and  could 
do  more  work  and  for  longer  periods  than  could 
his  spirit-drinking  fellows. 

Certainly  alcohol  taken  in  any  form  during  a 
day's  work  or  in  the  midst  of  a  task  (either  mental 
or  manual)  increases  fatigue  (after  possibly  a 
momentary  and  slight  increase  of  power);  and 
though  it  may  stimulate  and  for  a  brief  space 
make  one  unconscious  of  its  power,  alcohol  ends 
up  by  being  a  depressant.  Army  marching  tests, 
Marathon  races,  walking  contests,  have  proven 
alcohol  to  be  a  decided  hindrance  to  muscular 
or  athletic  power.  It  is  said  that  in  the  Arctics 
he  who  takes  any  alcohol  at  all  must  inevitably 
succumb  to  their  elemental  rigors. 

Also,  Dr.  Richard  M.  Cabot  declares  that  alcohol 
harms  the  mind  and  the  brain  more  than  it  does 
the  bodily  musculature;  that  the  brilliancy  which 
alcohol  has  long  been  supposed  to  give  to  mental 
work  is  a  popular  fallacy.  Its  seemingly  exhila- 
ratory  effects  are  a  delusion  because  they  depend 
on  the  blunting,  the  inhibition  of  the  higher  brain 
centers  (those  most  recently  developed,  and  the 
initial  step  in  the  evolution  of  the  possible  super- 
man). Dr.  Harvey  W.  Wiley  considers  it  doubtful 
whether   a   single   brilliant   thought   or   poetic   or 

190 


MATURITY 

elegant  expression  lias  owed  its  origin  to  alcohol 
in  any  form: 

It  is  true  that  alcohol  seems  to  take  the  bridle  off  the  tongue 
and  to  give  free  rein  to  conversation;  but  this  effect  is  by  a 
paralyzing  influence  on  the  sense  of  responsibility  rather 
than  by  a  stimulating  influence  on  the  general  flow  of  ideas. 
Even  a  pint  of  beer  will  lower  intellectual  power,  impair 
memory,  retard  simple  mental  processes,  produce  interference 
in  the  habitual  association  of  ideas.  To  be  below  par  is  almost 
as  disgusting  to  a  bright,  modern  man  as  drunkenness — and 
almost  as  dangerous.  Mere  weakness  of  body  and  mind, 
lassitude,  lack  of  brightness,  energy,  and  self-control  are 
often  brought  on  and  made  permanent  by  even  a  mild  use  of 
alcohol.  From  10  to  30  per  cent  of  all  mental  illness  is  due, 
in  part,  at  least,  to  alcohol. 

We  have  noted  how  the  most  of  venereal  disease 
is  contracted  by  young  men  under  the  alcoholic  in- 
fluence. Crime  is  generally  a  manifestation  of 
mental  aberration — temporary  or  chronic — and  this 
aberration  is  in  a  great  number  of  cases  due  to 
alcohol. 

THE   BENEFIT   OF   ALCOHOL 

All  of  which  is  no  doubt  true  enough.  But 
while  we  are  dealing  John  Barleycorn  all  sorts  of 
good  and  well-deserved  head  and  body  blows, 
let  us  deal  him  none  below  the  belt.  Let  us 
eschew  prejudice  and  admit,  not  only  frankly,  but 
also  gratefully,  that  there  are,  as  in  all  things 
cosmic,  some  good  points  about  alcohol.  The 
demand  for  it  exists  and  persists  all  over  the 
world;  for  it  is,  as  I  have  stated,  one  of  the 
body's  paratriptics.     And  all  the  fanatic  hypocrisy- 

191 


WHY  DIE  SO  YOUNG? 

saturated  enactments,  so  subversive  as  they  are 
of  the  personal  liberty  for  which  our  fathers  fought, 
so  abhorrent  as  they  are  to  the  fundamental 
spirit  of  all  good  law — any  number  of  prohibition 
amendments  never  have,  will  never  now,  never  can, 
remove  a  taste  so  legitimate  when  temperately  in- 
dulged and  so  fortified  in  human  experience.  For 
alcohol  has  had,  since  the  beginning  of  human 
history,  has  to-day,  its  righteous  and  justified  uses. 

A  single  point  in  its  favor  is  overwhelming — the 
sense  of  well-being  it  gives,  its  restorative  influence 
after  the  cares  and  the  stresses  of  the  workday; 
and  the  incentive  to  geniality  it  then  offers.  Those 
(and  there  are  many  such)  who  will  not  grant  this 
humanizing  influence  in  alcohol  should  be  excom- 
municate and  deprived  forever  of  the  comfort  and 
solace  there  is  in  human  companionship  and  of  the 
benefits  which  lie  in  the  support  and  sympathy 
of  all  generous  and  mellow  souls. 

Also,  for  the  sick,  the  debilitated,  and  the  elderly, 
wholesome  wines  and  pure  spirits  are  indicated 
to  be  prescribed  according  to  the  doctor's  judg- 
ment; this  is  the  opinion  of  a  practitioner  of  some 
quarter  of  a  century's  experience.  Read  here  also 
the  views  expressed  by  my  dear  colleague  and  most 
wise  physician,  Dr.  William  H.  Porter,  in  his  book, 
Food  as  an  Aid  to  Long  Life. 

Undoubtedly  there  has  lain  in  the  abuse  of  alcohol  more  of 
sorrow,  crime,  poverty,  vice,  and  misery  than  can  be  justly 
ascribed  to  any  other  agent  ever  used  by  human  beings. 

But  the  physician  interested  only  in  saving  life  and  in 
helping  those  sorely  tried  by  unhealthful  processes  has  often- 
times to  use  a  readily  convertible  heat  and  energy  producer 
for  those  who,   lacking   this   stimulus,   must  inevitably  die. 

192 


MATURITY 

Such  sufferers  cannot,  in  their  extremity,  in  their  pitiful 
debility,  get  this  stimulus  out  of  ordinar}'  food. 

Nothing  so  far  known  can  take  the  place  of  alcohol  in  such 
crises  where  life  hangs  by  the  slenderest  of  frayed  threads. 

In  serious  pulmonary  diseases,  such  as  pneumonia,  in  many 
infectious  states,  in  conditions  where  there  is  much  depression, 
and  where  much  tonic  material  has  been  absorbed,  alcohol 
has  helped  the  physician  to  save  many  lives  which  would 
otherwise  have  ended  long  before  the  human  span.  The  dif- 
ference in  the  results,  as  compared  with  the  same  type  of 
patient  to  whom  alcohol  was  denied  in  the  treatment,  speaks 
for  itself  in  the  records  of  hospital  mortality  statistics. 
The  fact  is,  in  treatment  of  the  kind  of  diseases  here  mentioned, 
the  doctor  could  not  do  justice  to  his  stricken  patient  if  he 
should  withhold  good  whisky  and  good  brandy;  nor  is  there 
anything  to  take  the  place  of  such  readily  oxidizable  stimulus. 
No  other  agent  at  the  command  of  the  doctor  is  as  dependable; 
many  years  of  experience  with  thousands  of  most  desperate 
cases  demonstrate  beyond  peradventure  the  therapeutic  value 
of  alcohol  in  grave  and  toxic  conditions.  It  is,  in  sickness,  the 
one  product  which  yields  force  without  taxing  the  digestion, 
without  which  the  patient  simply  dies  from  nerve  exhaustion 
and  uneliminated  toxins. 


THE   PUBLIC   HEALTH 

The  adult  individual  should  manifest  real  interest 
in  public  health  matters.  In  fulfilling  this  funda- 
mental citizen  obligation,  not  only  will  the  body 
politic  be  served,  but  the  health  of  the  political 
unit  and  of  the  family  will  also  be  in  very  large 
part  assured. 

Mr.  Elihu  Root  has  in  nothing  else  so  well 
shown  his  genius  for  statesmanship  as  in  his 
observation  that  what  we,  after  all,  have  govern- 
ment for  is  primarily  the  protection  of  the  home 
against  spoliation;    for  the  protection  of  the  lives 

193 


WHY  DIE  SO  YOUNG? 

of  its  inmates  against  violence  and  the  assassin. 
This  principle  of  government  is  truly  basic  in 
civilization,  has  been  so  these  many  centuries 
past.  But  only  of  recent  years  has  the  equally 
fundamental  principle  been  recognized  that  it  is, 
or  should  be,  the  government's  duty  to  safeguard 
the  home  and  to  protect  the  lives  of  the  citizen 
and  of  his  family  against  suffering  and  death 
from  infectious  disease.  It  is  here  no  more  in 
the  individual's  power,  of  and  by  himself,  to 
protect  himself  and  his  own,  than  it  is  for  him 
to  do  his  own  policing.  If  there  is  a  case  of  scarlet 
fever  on  the  floor  above,  or  of  typhus  in  the 
opposite  apartment  on  the  same  floor,  or  of  small- 
pox in  the  next  house,  or  if  there  is  pestilence- 
breeding  filth  in  the  next  yard,  the  individual 
has  not  of  himself  the  power,  does  not  of  himself 
know  how,  to  compel  the  isolation  of  the  sufferer, 
to  compel  his  neighbor  to  do  things  necessary  to 
prevent  the  spread  of  the  infection.  The  individual 
cannot  of  himself  prevent  the  contamination  by 
another  of  a  place  which  they  both  occupy.  And 
when  he  changes  his  habitation  he  has  no  assurance, 
save  through  the  health  authorities,  as  to  the 
sanitary  or  the  unsanitary  condition  of  the  place 
into  which  he  designs  to  move.  If  there  is  a 
diphtheria  epidemic  in  the  public  schools  he  cannot 
of  himself  guard  his  child  against  that  disease. 
In  short,  it  is  the  constituted  health  authorities 
in  whom  must  lie  the  conservation  of  the  communal 
health.  It  is  they  who  are  civilization's  sanitary 
police. 

It  is  by  reason  that  we  have  been  coming,  since 
the  birth   of  the   science   of  preventive   medicine, 

194 


MATURITY 

to  appreciate  the  supreme  importance  of  this 
principle  of  communal  sanitation,  that  almost 
every  village,  town,  county,  and  state  in  the 
nation  has  now  its  health  committee  or  board  or 
department.  Many  of  these,  the  majority  of 
them,  no  doubt,  are  bodies  adequately  fitted  for 
their  duties.  The  health  department  cannot, 
however,  be  supremely  serviceable  unless  the 
citizen  body  in  all  loyalty  hold  up  its  hands.  And 
this  support  can  only  be  assured  through  the 
development,  among  our  people,  of 

THE   SANITARY   CONSCIENCE 

Professor  Rosenau  of  Harvard  has  observed 
among  us  hundred  million  odd  the  awakening  of  a 
sanitary  conscience,  a  concomitant  of  the  sanitary 
renaissance  nurtured  by  Pasteur,  Koch,  and  their 
coworkers  these  several  decades  back.  The 
modern  science  of  disease  prevention  "teaches 
the  lesson  of  the  unselfishness  of  community 
interests  and  has  been  a  potent  biological  factor 
underlying  the  present  trend  toward  socialism." 

The  idea  of  conscience  is  pretty  sure  to  connote 
that  of  religion;  and  in  this  relation  one  inevitably 
recalls  Doctor  Eliot's  observation  that  in  the 
religion  of  the  future  preventive  medicine  must  as 
a  matter  of  course  find  high  place.  "Preventive 
medicine  is  capable  in  the  future  of  doing  away 
with  poverty  and  misery,  of  remedying  industrial 
disputes,  of  removing  those  causes  of  human 
misery,  poverty,  and  sorrow  which  lead  to  internal 
rebellion  and  disorder  and,  among  nations,  to  war 
and  strife.    We  are  going  to  get,  through  preventive 

195 


WHY  DIE  SO  YOUNG? 

medicine,  relief  from  frictions  which  arise  out  of 
immigration,  among  the  leading  nations  of  the 
world." 

The  driving  force  in  any  religion,  the  one  thing 
about  it  which  gives  it  such  potency  as  it  may  have, 
is  the  conscience  of  its  devotees.  And,  indeed, 
it  can  be  said,  with  confidence  and  with  gratification, 
that  the  sanitary  conscience  is  becoming  woven 
into  the  woof  of  our  twentieth-century  civilization, 
to  the  considerable  furtherance  of  the  Kingdom  of 
Heaven  upon  earth.  To  be  a  working  and  potent 
force  this  kind  of  conscience  has  got  to  interest 
itself  in  the  general  health,  that  of  the  community 
in  which  the  individual  is  the  social  unit.  Just 
as  the  individual  contracts  infection  by  reason  of 
two  factors — the  predispositions  making  the  body 
vulnerable,  and  the  specific  cause — so  with  regard 
to  the  communal  morbidity  everyone  who  has  the 
sanitary  conscience  in  robust  working  order  will 
consider  both  the  general  conditions  predisposing 
to  disease  and  the  specific  epidemics  that  may 
endanger  the  body  politic. 


THE  PRIME  OF  LIFE 

"And  then  the  justice 
In  fair  round  belly  with  good  capon  lined, 
With  eyes  severe  and  beard  of  formal  cut, 
Full  of  ivise  saws  and  modern  instances; 
And  so  he  plays  his  part." 

LIFE   EXPECTANCY   AFTER   FORTY 

SINCE  the  middle  of  the  nineteenth  century, 
and  wherever  the  modern  science  of  disease 
prevention  has  been  permitted  to  exert  its  benefi- 
cent influence,  the  average  span  of  human  life 
has  been  much  prolonged.  In  fatalistic  India, 
where  the  faithful  Mohammedan  still  heeds  the 
Koran's  adjuration  not  to  flee  from  the  wrath  of 
Allah,  life's  duration  remains  pretty  much  what 
it  has  been  for  centuries  past — that  is,  about 
twenty-five  years.  In  Sweden,  on  the  other 
hand,  where  our  God-bestowed  faculties  are  exer- 
cised in  the  furtherance  of  human  health  and  well- 
being,  life  in  general  now  endures  to  past  fifty 
years.  In  Europe  as  a  whole  length  of  days  is 
now  double  that  of  three  centuries  ago.  The  rate 
of  increase  between  the  seventeenth  and  eighteenth 
centuries  was  about  four  years.  It  was  about 
nine  years  during  the  first  half  of  the  nineteenth 
century — the  "human  pigsty  era"  in  England, 
14  197 


WHY  DIE  SO  YOUNG? 

when  Dickens  declared,  in  a  public  meeting  in 
1850,  that  he  knew  of  "many  places  in  London 
unsurpassed  in  the  accumulated  horrors  of  their 
long  neglect  by  the  filthiest  old  spots  in  the 
dirtiest  old  towns  under  the  worst  old  governments 
in  Europe." 

In  the  latter  half  of  the  nineteenth  century, 
however,  a  truly  epochal  sanitary  renaissance 
took  place,  the  genesis  having  been  due  to  Pasteur's 
discovery  that  germs  are  the  essential  causes  of 
the  infectious  diseases,  and  to  the  great  French- 
man's dictum  that  "it  is  within  human  power  to 
banish  all  parasitic  diseases  from  the  face  of  the 
earth."  Consequently  life  throughout  civilization 
has,  since  1860,  been  prolonged  seventeen  years. 

And  yet,  though  length  of  days,  counting  from 
babyhood  to  old  age,  has  been  prolonged,  by 
reason  of  the  wonderful  advances  in  the  prevention 
and  treatment  of  the  childhood  infections,  the 
duration  of  life  expectancy  after  forty  has  been 
diminished. 

Three  decades  ago,  forty-one  years  longer  could 
be  expected  for  a  child  under  five;  while  for  a 
child  of  that  age  an  additional  fifty-two  years 
may  now  be  anticipated — that  is,  eleven  years 
more  may  be  added  to  its  life.  A  person  aged 
twenty-five  had,  three  decades  ago,  an  expectancy 
of  thirty-two  years  more — that  is,  he  could  hope 
to  live  to  be  fifty-seven  years  old.  While  such  a 
one  may  now,  because  of  improved  management 
of  the  ailments  to  which  early  maturity  is  prone, 
hope  for  thirty-four  years  more — that  is,  he  can 
live  to  be  fifty-nine  years  old.  He  will  thus  have 
two  more  precious  years  added  to  the  latter  end 

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THE  PRIME  OF  LIFE 

of  his  life,  when  there  are  so  many  things  undone 
one  wants  to  complete;  when  one  wants  so  much 
to  keep  on  enjoying  the  sunshine  and  the  leafy 
shade,  the  breezes  and  the  sunsets,  the  perfume 
of  the  flowers,  and  the  song  of  birds;  when  one, 
above  all,  yearns  to  bask  still  a  little  longer  in  the 
dear  companionship  of  one's  own,  in  this  life, 
all  too  brief  at  the  longest  and  which  is  all  so 
pathetically  rounded  in  a  sleep. 

But  whereas,  those  who  three  decades  ago  had 
reached  forty  years  could  hope  for  twenty-three 
and  nine- tenths  years  more  of  life,  such  expectancy 
is  now  twenty-three  and  four-tenths  years,  or 
five  months  less  of  life.  And  thence  the  diminu- 
tion has  come  to  be  almost  steadily  progressive 
with  each  succeeding  five-year  period,  as  any  life 
insurance  actuary  will  demonstrate. 

And  apart  from  one's  interest  in  himself  the 
losses  of  men  past  forty  are  peculiarly  unfortunate 
for  their  communities.  Because,  after  all  is  said 
and  done,  of  such  men  in  the  main  are  the  world's 
real  achievers  and  compellers,  its  most  influential 
realizers  of  ideals.  How  important,  then,  to  take 
into  account  the  untoward  factors  that  tend  to 
endanger  the  physique  and  the  psychism  of  the 
man  turned  twoscore!  The  expectancy  of  life 
is  now  greater  among  females  than  among  males 
before  forty;  but  after  forty  the  reverse  obtains — 
among  males  at  all  ages  the  increased  expectancy 
up  to  forty  is  almost  twenty-five  years,  among 
females  twenty-nine  years;  after  forty  the  di- 
minished expectancy  among  males  is  now  fifteen 
years  and  among  females  eighteen  years. 

No   doubt   the   modern   increase   in   cancer,   a 

199 


WHY  DIE  SO  YOUNG? 

disease  of  later  life  and  one  form  of  which  women 
suffer  exclusively,  will  account  for  some  of  this 
diminished  expectancy.  But  the  factory  work  of 
women,  and  which  they  seem  to  do  in  our  era 
to  an  unprecedented  degree,  must  surely  explain 
a  great  deal  of  diminished  female  expectancy  after 
forty.  Here  is  a  form  of  slavery  peculiarly  pitiful, 
when  one  considers  that  much  of  the  work,  in 
itself  terribly  exhausting,  is  done  by  prospective 
mothers,  and  by  those  whose  strength  should  be 
conserved  for  giving  their  infants  the  breast.  It 
has  been  demonstrated  that  the  cotton-mill  in- 
dustry, which  employs  more  women  and  children 
than  does  any  other,  exhibits  a  grievously  high 
female  death  rate;  and  it  especially  subjects  its 
workers  to  inhalations  of  irritant  vegetable  dust — 
a  fact  very  conducive  in  the  underfed  and  the  over- 
worked to  pulmonary  diseases. 

Within  a  score  of  years,  indeed,  the  degenerative 
diseases  have  been  taking  more  lives  than  formerly; 
there  has  been  a  great  increase  in  the  mortality 
from  affections  especially  of  the  vital  organs — 
heart,  kidney,  stomach,  liver,  intestines.  Pari 
passu  there  has  been  an  increase  in  the  consumption 
of  spirituous  liquors  and  of  nitrogenous  articles 
of  food  (meats) .  The  wear  and  tear  of  the  strenuous 
life  is  also  a  factor  in  this  increase  of  the  death 
rate.  The  introduction  of  easy,  comfortable  and 
rapid  means  of  transportation  has  seduced  to  his 
undoing  the  average  individual  from  his  daily  exer- 
cise in  the  open  air. 

Unquestionably  the  mortality  from  the  diseases 
common  to  middle  life  and  old  age  has  increased 
within  a  generation.     For  New  York  State  alone 

200 


THE  PRIME  OF  LIFE 

the  increase  in  kidney  disease  has  been  estimated 
at  73  per  cent;  in  heart  disease  84  per  cent;  in 
apoplexy  34  per  cent;  in  pneumonia  24  per  cent. 

It  has  been  questioned  if  bachelors  have  not  a 
still  further  diminished  life  expectancy  after  forty 
than  married  men.  Anyone  perturbed  in  these 
premises  may  be  assured  that  the  expectancy  is 
about  the  same.  In  proof  of  which  is  the  conclusion 
of  a  German  scientist  (whose  proverbial  Teutonic 
thoroughness  and  profundity  in  investigation  was 
as  usual  offset  by  lack  of  humor)  that  "married 
men  really  do  not  live  longer  than  single  men — 
it  only  seems  longer." 

One  consideration  appears  to  me  the  most 
vital  of  all,  and  it  is  one  that  few  indeed  in  this 
materialistic  age  ever  bother  about — in  fact,  rather 
scorn — and  that  is  the  psychic  element.  Physio- 
logically all  work  is  brain  work,  all  life  stress  is 
brain  stress.  "The  spirit,"  declared  Schopenhauer, 
"has  all  matter  to  choose  from";  and  a  perverse, 
perverted  spirit  is  bound  to  choose  cancer  cells 
rather  than  healthy  ones,  is  likely  in  the  course  of 
time  to  substitute  a  hobnailed  liver  for  one  that 
should  in  old  age  functionate  aright  (so  that  a 
life  which  depends  on  so  debauched  a  liver  will, 
indeed,  not  be  worth  living).  It  were  indeed 
difficult,  though,  as  we  have  seen,  some  such  things 
have  been  done,  to  gauge  the  psychic  influence  on 
the  physical  tissues,  to  compute  the  extent  to 
which  thought  can  effect  the  development  of  a 
white  blood  corpuscle,  the  making  of  a  drop  of 
lymph,  or  the  behavior  of  an  excretory  cell.  The 
process  is  hardly  susceptible  of  investigation  by  the 
microscope.     Yet  what  is  more  obvious  than  the 

201 


WHY  DIE  SO  YOUNG? 

influence  of  the  mind  over  the  body?  Is  it  not  in 
every  one's  experience  that  mental  perturbations — 
as  acute  shock  from  sudden  grief  or  bad  news — 
gravely  derange  the  functions  of  the  various  organs? 
And  will  not  chronic  shock,  such  as  through  years 
accompanies  exhaustion,  or  overwork  or  anxiety, 
predispose  to  graver  affections  in  later  life? 

The  soul,  for  many  Americans,  before  the  war 
ennobled  us,  was  too  much  for  the  things  of  lesser 
importance,  too  little  for  the  real  things  of  life. 
Money  getting  has  been  the  game  played  day  and 
night,  and,  like  that  of  the  athlete,  always  to  win. 
All  the  waking  hours  have  been  given  to  this 
game,  while  the  soul  has  been  starving  for  the 
things  really  worth  while,  the  intellectual  pleasures, 
the  cultivation  of  music  and  the  arts,  for  whole- 
some hobbies,  for  the  rich  humanities;  for  these 
the  soul — the  psyche — has  hungered  and  has  been 
all  unsatisfied  and  flouted.  What  wonder,  then, 
that  in  later  life  such  a  soul  acts  like  Poe's  Imp  of 
the  Perverse  and  plunges  the  body  to  destruction, 
all  before  its  natural  limit  has  been  reached. 

CANCER 

The  most  sinister  among  the  physical  degen- 
erations which  one  in  his  prime  must  consider  is 
cancer.  Some  "knocker"  has  observed  that 
doctors  now  save  the  lives  of  young  people  from 
consumption  in  order  that  they  may  die  later  of 
cancer.  But  this  is  hardly  so.  While  the  Captain 
of  the  Men  of  Death — the  pregnant  phrase  is 
John  Bunyan's — has  been  claiming  his  victims 
mostly   from   humanity's   submerged   strata,    the 

202 


THE  PRIME  OF  LIFE 

"down  and  out,"  the  exhausted  in  body  and  soul, 
the  starved  and  the  wretched;  cancer,  "the  crab," 
on  the  other  hand,  is  like  to  reach  out  its  tentacles 
rather  for  the  fortunate,  those  accustomed  to 
generous  and  eupeptic  existence.  This  does  not 
invariably  hold,  of  course,  for  many  very  poor 
people  have  cancer.  And  yet  the  conditions  condu- 
cive to  good  living  would  seem  really  congenial 
to  this  disease,  which  thrives  quite  companionably 
with  gout.  Patrician  cancer  aims  for  the  shining 
mark — the  illustrious,  those  whom  nationalities 
even  can  ill  spare.  Cancer  is  like  to  strike  at 
those  who  have  through  many  useful  years  earned 
a  serene  old  age.  How  often  is  such  otium  cum 
dignitate  unrealized,  considering  that  among  every 
ten  middle-aged  Americans  one  at  least  meets 
this  "slow  and  agonizing  death." 

Cancer  furnishes  one  of  the  few  problems  remain- 
ing for  medical  science  to  solve.  Its  essential 
nature  is  not  yet  fully  determined.  We  know 
some  of  the  causes  of  cancer;  we  know  a  great 
deal  about  how  cancer  manifests  itself;  we  know 
how  a  fragment  of  cancerous  tissue  looks  under 
the  microscope  and  can  thus  determine  the  presence 
of  the  disease  in  the  sufferer's  body;  but  we  do 
not  yet  surely  know  the  essential  nature  of  this 
malignant  growth.  The  study  of  cancer  is  intense; 
the  civilization-wide  field  has,  for  a  generation 
past,  been  entered  by  so  many  and  experienced 
delvers,  all  in  generous  rivalry  to  be  the  first  to 
bestow  upon  their  kind  the  epic  boon;  so  abundant 
are  the  material  resources  which  the  sympathetic 
rich  have  put  to  the  service  of  those  workers;  so 
nobly  striving  and  so  distributed  are  the  cancer 

203 


WHY  DIE  SO  YOUNG? 

research  institutions;  so  effective  are  such  organi- 
zations as  the  American  Society  for  the  Control 
of  Cancer;  so  loyal  is  the  co-operation  of  govern- 
ments— that  the  unraveling  of  the  cancer  mys- 
stery  can  now,  surely,  be  not  much  longer  delayed. 
And  immediately  this  mystery  is  solved  we  may 
be  sanguine  of  some  rational  prophylactic,  of  some 
scientific  curative  agency  other  than  the  knife. 
At  present,  however,  the  cancer  situation  requires 
that  the  physician  shall  draw  public  attention  to 
certain  danger  signals,  by  heeding  which  the 
lives  of  at  least  half  those  eighty  thousand  who 
succumb  yearly  in  the  United  States  to  this  disease 
may  be  saved.  "What  cannot  be  cured  may  be 
prevented";  and  those  who  do  not  lack  the 
courage  to  observe  the  signals  shall  not  die  if 
they  will  but  act  with  promptitude  before  the 
ramifications,  into  regions  inaccessible  to  the 
surgeon's  knife,  of  "cancerous"  offshoots,  all  of 
which  must  be  removed,  with  the  malign  body 
itself,  for  a  certain  cure  to  be  established. 

There  is  probably  little  danger  from  cancer 
heredity  except  when  the  disease  has  been  on 
both  sides  of  the  family.  In  such  contingency 
one  who  notices  any  persistent  inflammation,  in 
the  mouth  especially;  or  whose  indigestions  are 
not  easily  relieved ;  or  who  has  inexplicable  abdom- 
inal pain  or  whose  organic  functions,  this  or  that, 
are  not  working  aright;  whose  organs,  indeed, 
give  evidence  (as  they  ought  not  to)  of  their 
presence  in  the  body — should  at  least  yearly  consult 
medical  advisers  of  tried  skill  and  experience. 
By  such  forethought  may  forty  thousand  of  our 
people  be  saved  annually  from  cancer  deaths. 

204 


THE  PRIME  OF  LIFE 

"We  know  this  most  important  thing  about 
cancer — that  certain  bodily  conditions  and  ailments 
predispose — make  one  susceptible  to  its  develop- 
ment. Many  cancerous  growths  have  their  seat 
in  organs  that  have  constantly  been  overworked 
and  clinkered  up,  with  few  intervals  for  normal 
rest,  by  their  hearty-living  owners.  Except  after 
blows  or  injuries  cancer  will  not  otherwise  develop 
in  healthy  tissues. 

THE  PRECANCEROUS  STAGE 

In  nearly  half  the  cancer  cases  there  has  been 
the  precancerous  stage,  which  ought  to  have 
been  detected.  Weakened  bodily  conditions,  and 
ailments  not  in  themselves  serious,  combined  with 
the  factor  of  chronic  irritation,  make  many  sus- 
ceptible. "Benign"  tumors,  not  in  themselves 
death-dealing;  persistent  ulcerations,  especially  of 
the  stomach;  long-continued  inflammations;  un- 
repaired injuries,  after  blows,  perhaps,  or  injuries 
the  recovery  from  which  has  been  long  delayed; 
abnormal  tissue,  such  as  scars  or  stumps  from 
old  wounds  or  operations;  dragging,  gnawing,  and 
strength-sapping  adhesions  within  the  abdomen 
and  pelvis,  especially  in  women — such  are  condi- 
tions which  must  receive  the  doctor's  attention. 
Every  "lump"  or  sore,  however  painless,  especially 
of  the  breast,  should  without  delay  be  examined 
by  him.  Every  tumor,  no  matter  how  innocent 
it  may  seem,  should,  if  operable,  be  referred  to  the 
surgeon  for  his  decision  as  to  whether  cancerous 
infiltration  has  taken  or  may  take  place  in  it. 
All  tumors  are  not  cancers,  happily — to  the  doctor 

205 


WHY  DIE  SO  YOUNG? 

all  kinds  of  swellings,  and  there  are  at  least  a 
score  of  them,  are  classed  as  tumors — and  there 
are  several  kinds  of  cancer,  differing  in  degree  of 
malignancy  and  in  their  courses.  Superficial 
cancers,  as  of  the  face  and  lip,  are  reasonably 
recognizable  by  sight,  touch,  and  microscopic 
examination. 

Deep  seated  cancers  are  often  difficult  to  detect. 
Oftentimes  the  only  indication  of  them  is  functional 
disturbance  of  the  organs  involved,  perhaps  also 
of  associated  organs  and  tissues.  Women,  es- 
pecially those  after  forty,  should  go  without 
delay  for  examination  as  to  the  ailments  and 
persistent  discomforts  peculiar  to  their  sex.  Men 
past  forty — especially  alcoholics,  constant  smokers, 
and  heavy  diners,  men  who  are  family  bread- 
winners, and  those  who  have  weighty  business 
and  communal  responsibilities — should  see  to  the 
preservation  of  their  lives  by  yearly  examinations. 

THE  CHIEF  DANGER  SIGNAL 

One  must  now  see  that  the  chief  danger  signal 
by  which  one's  active  attention  should  be  directed 
to  the  cancer  peril  is  the  factor  of  irritation,  which, 
working  through  months  or  years,  fosters  ma- 
lignancy at  its  site. 

Thus  there  comes  the  pipe  smoker's  cancer,  on 
the  lip;  there  used  to  be  the  chimney  sweeper's 
cancer;  there  is  the  cancer  of  the  tongue  from  the 
jagged  edge  of  an  untreated  tooth;  the  throat 
cancer  from  the  inveterate  smoking  of  strong 
tobacco;  the  cancer  from  radium  burns.  (How 
many  a  martyr  in  medicine,  nursing,  and  the  allied 

206 


THE  PRIME  OF  LIFE 

professions  has  suffered  thus!  There  is  the  cancer 
from  prolonged  exposure  to  the  sun;  that  which 
has  originated  in  insect  bites  or  by  the  fastening 
of  parasites  upon  the  intestinal  mucous  membrane; 
the  cancer  from  betel-nut  chewing,  in  India;  from 
eating  very  hot  rice,  in  China.  The  Tibetan 
natives  carry  in  their  tunics,  against  the  abdomen, 
a  kind  of  pocket  stove,  the  kankri,  the  constant 
use  of  which  excites  at  the  site  of  the  burn  the 
kankri  cancer. 

Function  and  structure  are  just  as  inseparable 
as  mind  and  matter;  therefore  prolonged  un- 
healthy functioning  is  bound  sooner  or  later  to 
lead  to  diseased  structure.  That  is  why  persistent 
anaemia  (poor  blood),  nausea,  change  of  color, 
indigestion,  loss  of  weight  and  of  strength,  bleeding 
from  the  stomach,  uneasiness,  pain  or  tenderness 
on  pressure  below  the  breastplate,  should  excite 
apprehension. 

Pain  is  considered  to  indicate  cancer  and  the 
absence  of  sensation  to  remove  the  occasion  of 
fear;  but  this  were  indeed  a  broken  reed  to  rely 
on,  for  even  advanced  cancers  have  given  no  pain. 
Another  classic  symptom  is  supposed  to  be  the 
bleeding  from  the  stomach,  which  has  a  coffee- 
ground  appearance  by  reason  of  the  corroding 
effect  of  the  acid  gastric  juice.  Here  is  a  sign  of 
late  though  not  necessarily  incurable  cancer.  And 
yet  I  know  of  a  most  heartrending  case  where  oper- 
ation was  utterly  unavailable,  in  which  examination 
of  the  stomach  contents  revealed  absolutely  no  trace 
of  even  "occult  blood,"  in  which  there  was  no 
palpable  swelling,  and  the  sufferer,  so  dear  to  her 
people,  felt  practically  no  pain. 

207 


WHY  DIE  SO  YOUNG? 

Wherefore  it  is  now  sound  doctrine  among  the 
faculty  that  in  all  cases  of  men  and  women  over 
forty  with  stomach  symptoms  and  rapid  emacia- 
tion— cases  in  which  there  has  not  been  for  several 
weeks  response  to  the  treatment  that  is  generally 
effective — exploratory  opening  of  the  abdomen  be 
made  for  a  settlement,  beyond  a  peradventure,  of 
the  diagnosis;  also  that  the  surgeon  should  pro- 
ceed at  the  time  of  the  operation  to  the  extirpation 
of  any  malignant  growth  that  may  appear.  The 
X-ray  is  also  a  most  important  means  of  diagnosis, 
when  employed  in  conjunction  with  others. 

THE   ONLY   CURE  TO-DAY 

The  only  hope  to-day  lies  in  operation,  and 
surgeons  have  thus  cured  many  patients.  The 
disease  is  always  localized  at  first;  and  then  its 
prompt  removal  gives  the  best  chance.  If  the 
surgeon  can  act  during  the  precancerous  stage,  so 
much  the  better.  WThat  is  the  percentage  of  such 
cures?  Some  operators  have  demonstrated  80  per 
cent.  Operations  early,  and  with  extension,  have 
given  50  per  cent  of  cures.  WThen  complete  re- 
moval is  impossible,  operation  will  work  temporary 
relief,  but  generally  there  will  be  recurrences  and 
no  absolute  cure.  Even  in  such  cases,  however, 
there  has  been  (though  very  rarely)  "subsidence  of 
the  growth"  and  an  end  of  the  disease. 

"But  operations  are  such  dreadful  things!" 
Nonsense.  Anaesthesia  is  to-day  generally  begun 
with  laughing  gas,  so  that  after  a  few  whiffs  there 
is  nothing  more  to  it,  so  far  as  the  "going  under" 
is  concerned,  than  when  one  has  his  tooth  pulled 

208 


THE  PRIME  OF  LIFE 

"with  gas."  There  is  a  way,  applicable  to  many 
cases,  in  which  the  nurse  puts  her  patient  quietly 
to  sleep,  and  when  the  latter  awakes  and  asks 
at  what  time  the  operation  is  to  be  done,  she  is 
answered,  "It  has  been  done."  Surgery  is  nowa- 
days so  nearly  ideal  that  the  operating  table  in 
itself  is  really  a  good  deal  safer  in  our  riotous 
times  than  most  other  places.  Though  later 
operations  are,  of  course,  extensive,  severe,  and 
momentous,  operation  for  the  removal  of  early 
cancer  has  a  mortality  averaging  1  per  cent. 
Let  no  cancer  sufferer  delay.  Practically  all  the 
cases  that  are  let  alone  end  fatally.  The  earlier 
the  operation  the  better  the  hope  of  success.  Let 
this  be  known  and  we  shall  no  longer  have  to 
read  statements  to  the  effect  that,  largely  because 
of  public  ignorance  and  neglect,  cancer  now  proves 
fatal  in  over  90  per  cent  of  the  cases. 

THE  MODERATE   DRINKER 

The  effects  of  alcohol  are  really  more  pernicious 

on   the   so-called   moderate  drinker   than  in  him 

who  occasionally  becomes  bestially  drunk.      The 

moderate    drinker   is    never — well,    hardly    ever — 

visibly  intoxicated.     He  does  not  stagger  about, 

or  draw  a  crowd  on  the  streets,  or  insult  people,  or 

otherwise  make  a  degrading  exhibition  of  himself; 

nothing  so  low  as  that,  of  course.     Oh  yes,  once 

or   twice  a  year,   perhaps   at   an   anniversary,   or 

when   seeing   a  friend   off,   he   may   talk   a   trifle 

thick,  say  things  he  is  heartily  ashamed  of  when 

reminded  of  them,  and  be  a  trifle  wabbly  on  his 

pins;    but  surely  no  worse  than  that.     The  little 

209 


WHY  DIE  SO  YOUNG? 

he  takes  "certainly  cannot  hurt."  He  is  almost 
always  a  congenial  man,  a  good  fellow,  one  of 
the  coterie  that  have  from  youth  been  comrades. 
It  is  the  moderate  drinker  who  oftentimes  has 
the  sadly  diminished  life  expectancy  after  forty. 
Such  a  one  drops  out  of  the  circle  from  acute 
indigestion,  according  to  the  death  certificate; 
another  one  a  year  or  two  afterward  from  "Bright's 
disease";  another  presently  from  a  liver  gone 
wrong;  and  then  one  most  unexpectedly  from 
pneumonia.  "So  strong  he  seemed  and  so  florid 
of  face."  Queer  how  those  funerals  come  on  so 
soon,  one  after  another,  among  men  every  one  of 
whom,  you  would  think,  should  have  been  good 
for  at  least  threescore  and  ten.  At  fifty  few  of 
that  once  considerable  company  remain,  and 
after  each  funeral  the  survivors  get  together  and, 
while  sympathetically  and  heartily  recounting 
the  bonhomie  and  the  virtues  of  the  deceased, 
take  all,  most  fervently,  a  few  rounds  of  the  good 
old  stuff  in  his  memory.  Odd,  is  it  not,  that  in 
such  circumstances  alcohol  is  never  suspected  to 
be  the  underlying  cause  of  those  premature  deaths ; 
that  it  has  made  the  body  susceptible  to,  has 
predisposed  it  to,  those  fatal  diseases?  This 
alcohol  does  by  disorganizing  the  body's  natural 
defenses. 

WE    EAT    TOO   MUCH 

Any  family  doctor  will  tell  you  that  after  the 

summer  complaints  and  the  September  typhoids 

have  been  attended  to,  there  is  a  slump  in  practice 

until  after  Thanksgiving  Day,  when  he  is  called 

to   minister   unto   a  lot   of   indigestion   sufferers; 

210 


THE  PRIME  OF  LIFE 

after  which  things  professional  are  on  the  joyous 
hum  throughout  the  winter.  For  how  many  cases 
of  Bright's  disease,  rheumatism,  gout,  coughs  and 
colds,  pneumonia,  and  hardened  arteries,  and 
what  not  else  that  is  agonizing  are  set  a-going 
by  those  initial  Thanksgiving  orgies!  How  pithy 
a  saying  is  it  that  "many  of  us  dig  our  graves 
with  out  teeth." 

The  simple  fact  is  that  all  the  year  around  we 
Americans  eat  a  great  deal  more  than  we  need  to. 
The  traveler  visiting  us  is  amazed  at  the  variety 
and  plenitude  of  our  fare.  The  Englishman, 
especially,  comes  to  us  from  his  inn  at  home 
where  the  traditional  mutton  chop,  eggs,  marma- 
lade, and  some  half  a  dozen  other  eatables,  ex- 
cellently prepared,  are  ample;  in  most  of  our 
hotels,  on  the  other  hand,  whether  rural  or  urban, 
his  bewildered  eyes  see  a  hundred  things  on  the 
breakfast  card,  many  of  them  very  badly  cooked 
indeed.  And  he  will  find  the  contrast  at  lunch 
and  dinner  even  greater.  The  steerage  immigrant 
has  at  home  fared  very  well  indeed  on  his  plain 
bread,  vegetables,  and  his  stews — a  diet  into  which 
meat  will  enter  at  most  but  several  times  the  week. 
Our  overeating,  especially  of  meat,  is  the  con- 
comitant of  our  prosperity.  The  most  im- 
portant element  in  meat,  nitrogen,  can  be  had 
also  from  cheese — a  much-neglected  and  excellent 
food — peas,  beans,  nuts,  eggs,  and  bread.  Professor 
Chittenden,  who  was  very  authoritative,  thought 
our  present  dietary  standards  much  too  high; 
and  that  better  health,  increased  efficiency,  and 
greater  chances  of  longevity  would  certainly  follow 

upon  our  reducing  our  nitrogenous  foodstuffs  at 

211 


WHY  DIE  SO  YOUNG? 

least  50  per  cent;  that  such  organs  as  the  liver, 
stomach,  and  the  kidneys  become  overtaxed  in 
the  undue  efforts  they  have  to  make  to  dispose 
of  them.  And  when  this  overtaxing  is  long  con- 
tinued these  organs  are  bound  to  develop  chronic 
diseases  and  too  often  to  break  down  prematurely 
and  disastrously. 

TEMPERANCE   IN   EATING 

By  the  time  the  average  citizen  has  reached 
middle  life  he  is  supposed  to  have  stored  up  suf- 
ficient energy  to  carry  him  through  the  remainder 
of  his  days  in  good  health.  Yet  in  many  cases 
this  is  not  so,  because  the  system  has  been  over- 
strained by  too  hearty  indulgence  in  both  foods 
and  alcoholic  drink.  During  early  adult  life  the 
system  is  strong  enough  to  counteract,  up  to  a 
certain  point,  intemperance  in  eating  and  drinking; 
but  by  such  courses  the  body  is  not  storing  up 
the  energy  it  should.  And  so,  when  middle  life  is 
reached,  health  is  not  all  it  should  be.  For  these 
reasons  a  man  or  a  woman  of  forty-five  should 
not  drink  and  eat  as  heartily  as  during  the  younger 
years;  and  the  less  one  eats  when  he  arrives  at 
fifty  the  healthier  he  will  be. 

Having  a  splendid  appetite  in  youth  and  early 
maturity,  we  indulge  it,  disregarding  the  fact 
that  we  need  only  a  certain  amount  of  nourish- 
ment, and  that  whatever  we  eat  above  that  adds 
to  the  bulk  that  should  be  got  rid  of;  all  of  which 
means  extra  and  unnecessary  work  for  our  organs. 
Again,  in  middle  life  we  are  too  ready  to  ride 
instead   of  walk;   we   tend    to    give    up    exercise 

212 


THE  PRIME  OF  LIFE 

generally.  We  come  to  find  our  chief  pleasure 
in  eating  and  drinking.  And  so,  as  we  grow 
more  and  more  self-indulgent  we  become  stouter, 
and  our  surplus  girth  becomes  so  pronounced 
that  we  think  it  quite  natural  to  take  on  weight 
in  middle  life. 

The  worst  of  all  this  is  that  the  excess  of  waste 
matter  (due  to  eating  too  much,  especially  of 
animal  food  and  to  drinking  sweet  alcoholics) 
leads  to  most  of  the  headaches,  backaches,  rheu- 
matism, and  gout  of  middle  life. 

After  fifty  the  food  taken  should  be  just  enough 
to  keep  us  going  and  not  so  much  as  will  clinker 
up  the  system,  producing  the  ailments  just  men- 
tioned. The  middle-aged  can  do  very  well  with 
meat  once  a  day  and  no  alcohol;  they  will  actually 
enjoy  life  better  in  every  way  for  such  abstinence 
or  temperance.  One  will  have  a  clearer  mind, 
a  more  active  body,  if  he  takes  only  what  is  re- 
quired to  keep  up  a  fair  weight;  and  this  should 
be  the  test. 

Here  is  in  essence  what  Professor  Chittenden 
considered  a  fair  dietary  for  one  day. 

Breakfast:  One  shredded  wheat  biscuit,  one 
teacup  of  cream,  one  German  water  roll,  two 
cubes  of  butter,  three-fourths  of  a  cup  of  coffee 
and  one  lump  of  sugar.  Lunch:  One  teacup 
homemade  chicken  soup,  one  Parker  House  roll, 
two  one-inch  cubes  of  butter,  one  slice  lean  bacon, 
one  small  baked  potato,  one  rice  croquette,  two 
ounces  maple  sirup,  one  cup  of  tea  with  a  slice  of 
lemon  and  one  lump  of  sugar.  Dinner:  One  teacup 
of  cream  of  corn  soup,  one  Parker  House  roll, 
one-inch  cube  of  butter,  a  small  lamb  chop  broiled, 

15  213 


WHY  DIE  SO  YOUNG? 

one  teacup  of  mashed  potato,  apple-celery-lettuce 
salad  with  mayonnaise  dressing,  one  Boston  cracker, 
one-half  inch  cube  American  cheese,  one-half 
teacup  of  bread  pudding,  one  demi-tasse  of  coffee 
and  one  lump  of  sugar.1 

GOUT 

Some  people  speak  of  rheumatic  gout.  As  a 
little  girl  concluded  about  Santa  Claus,  that 
"there  ain't  no  such  a  person,"  so  there  is  no  such 
disease  as  rheumatic  gout.  Rheumatism  is  an 
infection,  due  to  an  essential,  a  specific  germ. 
The  essential  feature  of  gout  is  the  deposition 
into  and  around  joints  of  "chalky"  sodium  biurate 
crystals,  from  blood  that  has,  by  reason  of  abnormal 
metabolism,  become  surcharged  with  uric  acid. 
Right  metabolism  is  the  conversion  of  inspired 
oxygen — the  life-sustaining  gas — plus  the  fluids 
and  the  foodstuffs  that  are  ingested,  into  healthy 
blood  and  healthy  bodily  tissues.  Not  to  venture 
into  the  dense  mazes  of  organic  chemistry,  it  will 
suffice  to  note  that  the  "purin  bodies"  in  food, 
those  which  contain  considerable  nitrogen,  and 
which  tend,  therefore,  to  an  excess  of  uric  acid  in 
the  circulation,  should  be  minimized  (they  cannot 
entirely  be  avoided)  by  whomsoever  has  a  tendency 
to  gout. 

Who  tend  to  gout?  For  twenty-five  centuries 
past,  at  least,  this  podagra  has  always  paralleled, 
in  medical  annals,  high  and  riotous  living.  There 
was  no  end  of  gout  during  the  height  and  decline  of 
the  Roman  Empire.    Galen,  Celsus  (Nero's  doctor) 

1  Appendix  B,  on  further  dietetic  observation. 

214 


THE  PRIME  OF  LIFE 

and  their  colleagues,  throve  on  this  gutta,  this 
"dropping  of  morbid  material  from  the  blood  into 
the  joints."  Apart  from  high  living  there  is  a 
heredity  in  gout,  there  are  those  among  us  who 
spring  from  a  gouty  stock.  The  comparatively 
rare  cases  of  gout  in  women  are  thus  in  large 
part  explained.  One  may  be  spared  this  mani- 
festation if  other  causative  factors  are  prevented 
from  adding  their  weight  to  this  factor  of  heredity, 
if  anyone  with  such  an  inheritance  will  but  live 
the  hygienic  life,  will  guard  against  excess  in  food 
and  drink,  will  drink  tea,  coffee,  and  cocoa  moder- 
ately, will  be  very  temperate,  abstinent,  if  possible, 
as  to  alcohol  (port  especially),  will  guard  care- 
fully against  sudden  temperature  and  elemental 
changes — cold  and  wet,  against  chilling  of  the 
skin. 

There  is  a  relation  between  some  occupations 
and  gout — painters  are  prone,  also  decorators, 
plumbers,  printers,  lead-pipe  workers,  whitesmiths, 
tin  workers,  workers  in  lead  generally,  butlers, 
barmen,  cabmen,  draymen,  longshoremen,  hotel 
servants,  lobster-palace  waiters,  malsters,  cellar- 
men,  and  the  like. 

Among  the  purin-free  or  nearly  purin-free  foods 
are:  Milk,  eggs,  white  bread,  biscuits,  hominy, 
tapioca,  cornstarch,  rice,  farina,  sugar  and  sirup, 
jam  and  marmalade,  cake  (except  with  coffee  or 
chocolate  flavoring),  cream  soups,  potatoes  (eaten 
in  moderation),  cauliflower,  cabbage,  lettuce,  egg- 
plant, nuts,  cheese,  ice  cream,  custard  or  coconut 
pie.  Boiled  meats,  especially  if  boiled  in  two 
waters,  and  boiled  fish,  are  preferable,  because 
the  purins  are  thus  to  a  large  degree  removed 

215 


WHY  DIE  SO  YOUNG? 

from  them.  From  such  substances  as  these  one's 
physician  will  prescribe  a  dietary  when  one  has 
either  an  acute  attack  or  has  premonitions  of  an 
attack  of  gout  impending. 

The  gouty  must  abstain  from  any  food  which 
they  have  learned  from  experience  will  not  agree 
with  them.  Plenty  of  water  must  be  drunk,  because 
no  food  is  digested  or  absorbed  that  is  not  ulti- 
mately in  liquid  form.  No  one  prone  to  gout  should 
eat  sweetbreads,  kidneys,  liver,  meat  extracts, 
salt  fish,  roe,  caviar,  or  highly  seasoned  foods. 

OVERWEIGHTS 

The  tendency  to  obesity  is  almost  never  success- 
fully combated,  especially  if  there  is  a  family 
temperament  that  way.  Weight  is  indeed  often- 
times reduced  successfully  enough;  but  generally 
not  for  long,  and  in  many  cases  because  the  sufferer 
will  simply  not  exercise  the  will  power  to  stay 
reduced  by  keeping  away  from  the  fleshpots  and 
by  continuing  the  banting  regime. 

Obesity  results  from  long-continued  excess  in 
the  amount  of  food  consumed  over  that  which  is 
metabolized.  By  "metabolism"  we  mean  the 
conversion  of  the  oxygen  we  breathe,  plus  food- 
stuffs, into  our  flesh  and  blood,  our  bodily  heat, 
and  the  energy  we  manifest. 

Such  excess  may  be  the  result  of  too  much 
food  with  a  normal  metabolism;  or  because  of  a 
normal  amount  of  food  with  a  metabolism  that 
is  not  in  good  working  order;  or  on  account  of 
both  these  unheal thful  conditions  combined. 

When  stoutness  becomes  severe,  almost  every 
.    216 


THE  PRIME  OF  LIFE 

bodily  function  is  affected.  And  because  of  the 
many  vicious  circles  that  form,  we  have  to  deal 
with  a  self-perpetuating  and  self-aggravating 
malady  which  all  too  often  ends  fatally. 

For  instance:  a  heart  and  a  blood  circulation 
overtaxed  by  obesity  means  bodily  inactivity — 
which  in  its  turn  tends  to  increase  the  obesity. 
Hardening  of  the  arteries  and  chronic  kidney 
disease  (Bright's)  are  frequently  complications  of 
obesity;  in  time  they  recoil  on  the  heart  and 
eventually  on  the  obesity.  Again,  obesity  tends 
to  prevent  the  proper  expansion  and  aeration  of 
the  lungs,  which  leads  in  time  to  pulmonary 
disease;  which  later  induces  deficient  supply  of 
oxygen,  the  very  breath  of  life. 

Next  is  affected  the  circulation,  which,  in  its 
turn,  brings  about  diminished  metabolism;  and 
so  we  get  back,  in  the  vicious  circle,  to  obesity. 
In  like  manner  is  obesity  related  to  digestive, 
nervous,  muscular,  joint,  and  skin  diseases. 

There  are  some  diseases  of  later  life  which  come 
about  by  reason  of  fat  deposition  in  various  organs, 
and  against  which  the  individual  turned  forty 
and  inclined  to  stoutness  should  certainly  guard; 
excessive  weight  is  then  very  apt  to  be  associated 
with  an  increasingly  high  death  rate.  After  two- 
score,  then  fifteen  to  twenty  pounds  overweight 
should  send  one  to  his  physician  for  examination 
and  advice — without  which  no  reducing  measures 
should  be  undertaken.  Especially  is  this  so  re- 
garding exercise.  For  the  rapid  throwing  off  of 
many  pounds  has  proved  disastrous,  especially  in 
cases  of  fatty  heart  when  that  organ  becomes  di- 
lated to  well-nigh  the  rupturing  point.    Indeed,  the 

217 


WHY  DIE  SO  YOUNG? 

obese  have,   in  general,  diminished   resistance  to 
disease  processes. 

BANTING 

One  may  here  properly  indicate  the  foods  to  be 
avoided  by  the  obese.  These  are  alcohol,  especially 
beer;  beer  fat  is  pronouncedly  unhealthy  fat.  Also 
sugar,  fatty  meats  and  foods  in  general,  milk  as 
a  beverage,  potatoes,  salmon,  lobster,  crabs,  sar- 
dines, herrings,  mackerel,  pork,  goose,  nuts,  butter, 
cream,  and  water  during  meals.  The  meals  should 
be  light,  regular,  and  frequent  rather  than  that 
at  any  repast  the  stomach  should  be  overloaded. 
And  the  eliminating  organs  should  at  all  times  be 
in  good  working  order. 

The  immortal  Banting  devised  a  dietary  for  the 
obese  which  many  cannot,  however,  endure;  they 
frequently  collapse  after  using  it  a  few  days.  The 
following,  the  Banting  regime  modified  by  the 
physician  Oertel,  is  better  borne. 

Breakfast:  wheaten  bread,  one  ounce;  coffee,  four  ounces 
with  an  ounce  of  milk  and  a  teaspoonful  of  sugar;  two  soft- 
boiled  eggs.  At  11  a.m.,  four  ounces  of  wine,  bouillon,  or 
water;  cold  meat,  two  ounces;  rye  bread,  one  ounce.  Dinner: 
wine,  four  ounces;  fried  beef,  five  ounces;  salad,  two  ounces; 
pudding,  four  ounces;  bread,  one  ounce;  fruit,  three  ounces. 
At  4  p.m.,  half  a  cup  of  coffee;  one  ounce  of  milk;  a  teaspoonful 
of  sugar.  Supper:  wine  or  water,  eight  ounces;  caviar,  three 
teaspoonfuls;  venison,  five  ounces;  cheese,  half  an  ounce; 
rye  bread,  three  to  four  ounces;  fruit,  four  ounces. 

Hot  baths  and  massage  are  considerable  aids.  Certain  drugs 
have,  under  the  physician's  care,  been  helpful;  taken  hap- 
hazard, there  have  been  serious  consequences. 

The  dietary  can  be  taken  for  a  few  days  at  a  time,  until 
some  ten  pounds  or  so  are  disposed  of,  and  when  the  patient 
can  relinquish  it  for  a  while.     His  scheme  calls  for  an  early 

218 


THE  PRIME  OF  LIFE 

breakfast  of  a  cupful  of  tea  without  milk  or  sugar  (saccharin 
to  sweeten,  if  you  like);  an  ounce  and  a  half  of  ham  and  a 
dry  roll  (without  butter).  At  10  a.m.,  fresh  fruit,  and  the  same 
at  noon.  Then  at  2  p.m.,  a  moderate  cupful  of  clear  soup, 
lean  meat,  and  plenty  of  green  vegetables  without  butter  or 
bread  or  milk;  salad;  one  or  two  glasses  of  lemonade  without 
sugar  (saccharin  to  sweeten).  At  4  p.m.  a  cup  of  tea;  at  6 
p.m.,  fruit;  at  8  p.m.,  three  ounces  of  lean  meat,  radishes,  a 
small  potato,  and  some  pickles. 

When  this  dietary  gets  on  one's  nerves,  it  can  be 
abandoned  for  a  few  days  and  taken  up  again  for  a 
few  days  from  time  to  time. 

No  obesity  cure  should  be  attempted  by  any 
woman  who  has  an  organic  malady,  especially  in 
the  pelvis.  With  especial  caution  must  reducing 
be  proceeded  with  in  women  ill  of  serious  disease, 
or  who  have  suffered  ailments  that  may  have  left 
any  vestige  in  the  body.  Reducing  exercises  are 
only  for  women  in  perfect  health  except  for  over- 
weight. And  the  reducing  must  cease,  temporarily, 
at  least,  when  distress  or  weak  feeling  attends  it. 
Indeed,  in  any  case  it  is  much  better  for  the 
aspirant,  no  matter  how  well  she  thinks  herself, 
to  undergo  a  thorough  examination  by  a  competent 
physician  before  undertaking  any  reducing  system. 

THE  UNDERWEIGHTS 

What  should  those  who  are  underweight  do? 
We  have  considered  those  who  have  weakened  by 
some  serious  disease,  and  those  who  are  exhausted 
from  overwork  or  have  nervous  dyspepsia  and  do 
not  eat  enough,  imagining  this  item  or  that  on  the 
bill  of  fare  is  not  good  for  them.  And  so  such 
folk  remain  thin. 

219 


WHY  DIE  SO  YOUNG? 

Here  is  not,  perhaps,  so  great  an  evil  as  obesity. 
"A  lean  horse  for  a  long  race."  The  lowest 
mortality  at  middle  life  is  found  among  those  a 
few  pounds  underweight.  Therefore  those  even 
in  advanced  life  who  are  spare  of  build,  unless 
they  are  extremely  so,  or  are  in  really  impaired 
health,  need  not  worry  unduly. 

Here  is  a  specimen  "superalimentation  regime" 
suitable  for  building  up  the  system: 

Breakfast,  before  8  a.m.,  oatmeal  with  butter,  or  farina 
with  cream;  two  eggs;  bread,  or  a  couple  of  rolls  and  butter; 
one  cup  of  coffee,  half  milk,  with  sugar.  At  10.30  a.m.,  one 
cupful  of  milk  with  one  raw  egg  beaten  up  in  it;  bread  and 
butter.  Lunch,  before  1  p.m.,  one  cup  of  bouillon  with  one 
egg;  one  or  two  rolls  with  butter;  tender  meat;  mashed  or 
baked  potato;  weak  tea,  half  milk,  with  sugar.  At  3.30  p.m. 
same  as  at  10.30.  Dinner,  before  7  p.m.,  cream  soup;  fish; 
tender  meat;  potatoes;  peas  or  beans;  bread  and  butter; 
stewed  fruits;  small  cup  of  coffee.  At  9.30  p.m.,  kumiss  or 
cocoa  and  crackers  and  butter. 

FUNCTIONAL   STOMACH   DISORDERS 

I  suppose  there  is  no  other  country  in  the  world 
where  there  is  so  vast  an  army  of  dyspeptics  as 
we  Americans  can  muster;  and  the  ranks  of  such 
among  us  are  made  up  of  those  neurotic  by  inheri- 
tance or  those  who  have  acquired  their  nervous 
dyspepsia  by  overwork,  worry,  excitement,  the 
pace  that  kills,  the  passion  for  mixing  in  with  the 
maddening  crowd,  or  of  getting  into  the  social 
world,  the  get-rich-quick  mania,  and — last  but  not 
least — eyestrain . 

With  such  dyspepsia  there  is  no  disease  of  the 
stomach  structure,  no  organic  trouble  such  as 
exists  in  chronic  gastritis.     The  ailment  is  func- 

22Q 


THE  PRIME  OF  LIFE 

tional  and  either  the  muscular  stomach  apparatus 
or  the  right  secretion  of  gastric  juice  or  the  sensory 
gastric  function,  or  two  together,  or  perhaps  all 
three,  are  at  fault. 

In  most  cases  of  nervous  dyspepsia  the  main 
element  at  fault  is  hyperacidity  or  superacidity. 
In  many  cases  the  superacidity  is  only  occasional, 
independent  of  food,  occurring  perhaps  at  night, 
or  early  in  the  morning,  with  gnawing  in  the 
stomach  and  "bilious  headache."  Strong  emotion 
may  bring  it  on. 

On  the  other  hand,  the  difficulty  may  be  due  to 
subacidity,  not  enough  gastric  juice,  or  to  the 
entire  absence  of  this  precious  substance.  The 
only  right  course  is  for  the  family  doctor,  or  the 
stomach  specialist  he  will  call  in  if  he  is  not  adept 
in  the  analysis  of  the  gastric  contents,  to  use  the 
stomach  tube  and  so  ascertain  the  real  nature  of 
the  malady,  whether  it  be  just  nervous  or  some- 
thing organic.  The  patient's  part  in  this  procedure 
is  jocularly  known  as  "swallowing  the  hose  pipe." 

Assuming  the  ailment  to  be  nervous  dyspepsia, 
the  underlying  nervous  element  has  in  each  indi- 
vidual case  to  be  removed.  The  patient's  general 
physical  and  mental  condition  is  improved  by 
rest,  change  of  scene  and  of  the  mode  of  living  by 
regulated  exercise,  proper  food  properly  eaten,  and 
by  leading  in  general  the  hygienic  life. 

GASTKITIS 

Gastric  catarrh  is  a  chronic  inflammation  of  the 
stomach.    The  causes  are: 

1.  Habitual  excessive,  irregular,  or  hasty  eating. 

221 


WHY  DIE  SO  YOUNG? 

The  most  of  us  eat  too  much,  anyway,  and,  as  the 
saying  is,  "dig  our  graves  with  our  teeth,"  and 
with  these  implements  all  too  often  notoriously 
broken  and  poor.  And  many  of  us  do  not  eat  at 
set  hours,  as  we  should — three  meals,  and,  if  hungry, 
a  snack  at  bedtime.  And  many  among  us  gulp 
down,  instead  of  chewing  properly,  our  food.  We 
do  not  make  of  a  meal  a  pleasant  domestic  cere- 
mony, but  as  if  it  were  something  to  be  got  through 
with  on  the  jump  and  away. 

2.  I  am  anxious  to  give  no  reader  offense;  I 
mean,  if  I  can,  to  keep  on  the  right  side  of  my 
women  readers;  and  yet  I  am  in  duty  bound  to 
state  that  very  much  of  the  food  we  eat  is  badly 
cooked.  Fried  food  especially  is  indigestible,  for 
this  is  coated  with  a  layer  of  fat  through  which 
the  gastric  juice  is  not  able  to  penetrate.  Improper, 
greasy,  poorly  cooked  food,  the  deadly  hot  bread, 
pastry,  excessive  drinking  of  water,  too  much  ice 
cream,  tea  tippling,  excess  as  to  coffee,  alcohol, 
and  tobacco,  such  are  forerunners  of  chronic 
gastritis. 

3.  WTierever  there  is  cancer,  or  ulcer,  or  enlarge- 
ment of  the  stomach;  whenever  there  is  liver 
trouble  or  chronic  heart  disease,  and  in  such  lung 
diseases  as  are  accompanied  by  disturbances  of  the 
circulation — in  all  such  cases  there  is  accompanying 
chronic  gastritis;  as  also  in  many  cases  of  blood 
poverty,  chronic  kidney  trouble,  gout,  diabetes, 
and  other  serious  diseases. 

A   GOOD   COOK 

Further  consideration  of  maladies  of  the  di- 
gestive tract  lies  within  the  province  of  the  family 

222 


THE  PRIME  OF  LIFE 

practitioner.  I  beg  here,  however,  to  dwell  for  a 
few  pages  on  a  most  monstrously  neglected  sub- 
ject— the  fine  art  of  cooking.  One  of  the  amazing 
incongruities  of  our  civilization — the  contempla- 
tion of  which  would  send  any  Martian  visitor 
among  us  scurrying  back  to  his  own  planet — is  the 
haphazard  way  in  which  we  prepare  the  substances 
designed  for  the  nourishment  of  our  bodies  and 
for  the  upkeep  of  our  souls.  In  The  Service  of  The 
King,  a  most  wise  clergyman,  under  the  pen 
name  J.  B.  Dunn,  has  written  of  what  happened 
at  a  religious  meeting.  When  asked  what  was 
the  greatest  need  in  his  mission  field,  he  startled 
his  women  questioners  by  replying,  "A  missionary 
cook."  They  thought  him  a  jester  and  frowned 
disapproval.  Their  astonishment  was  not  lessened 
when  he  produced  a  biscuit  which  he  asked  them 
to  examine.  It  was  almost  green  in  color.  "This" 
he  said,  "is  the  food  of  my  people  and  it  is  not 
Christian  food.  One-half  the  women  in  the  insane 
asylum  in  a  neighboring  state  are  farmers'  wives, 
suffering  from  melancholia,  and  the  superintendent 
assures  me  that  their  infirmity  is  due  to  eating 
bad  bread.  The  woman  who  could  teach  my 
people  how  to  make  decent  bread  on  an  open  fire, 
and  eradicate  a  pernicious  culmary  heresy  known 
as  'fry,'  would  win  sainthood,  and  her  grave 
would  become  a  shrine.  But  that  woman  would 
have  to  be  endowed  with  apostolic  common  sense 
and  must  have  received  the  unction  of  tact,  for 
the  saddest  feature  of  the  condition  I  have  depicted 
is  that  my  people  think  their  way  is  the  best  way 
in  the  world.  The  poor  woman  who  made  that 
biscuit  told  me  herself  that  she  was  a  born  cook. 

223 


WHY  DIE  SO  YOUNG? 

Her  husband  beats  her,  but,  alas!  finds  no  fault 
with  her  cooking.  He  has  never  known  any 
better." 

How  grave  a  sin  of  omission  has  been  committed 
in  that  no  niche  in  any  Hall  of  Fame  has  been 
prepared  to  commemorate  that  apostle  of  light, 
of  joy,  of  health,  and  of  longevity,  Brillat-Savarin, 
the  immortal  author  of  the  book  entitled  The 
Physiology  of  Taste. 

This  great  man  was  born  in  the  latter  half  of 
the  eighteenth  century,  and  died  some  eighty 
years  ago.  full  of  honors  and  having  the  universal 
respect  of  his  community  and  era.  And  the  book 
here  noted,  which  he  is  said  to  have  left  at  his 
death  as  a  legacy  of  good  and  wholesome  cheer  to 
his  friends,  is  saturated  with  the  flavor  and  charm 
of  many  genial  years. 

Some  people  have  an  idea  that  Brillat-Savarin 
was  all  for  grossness  and  overeating;  no  greater 
libel  could  ever  be  perpetrated.  The  same  was 
also  said  of  old  Epicurus;  yet  there  was  never  a 
more  temperate  man.  These  men  simply  taught 
and  practiced  the  wise  and  excellent  philosophy 
that  we  human  beings  are  entitled  to — nay,  that 
it  is  our  duty  to — enjoy  the  present  life  sanely 
and  temperately.  And  to  this  end  they  insisted 
that  discretion  and  moderation  were  essential  in  all 
things,  spiritual,  intellectual,  and  physical;  to 
them  the  glutton  and  the  debauchee  were  abhorrent 
and  detestable. 

Brillat-Savarin  comprehended  well,  and  so 
taught — that  he  who  ate  or  drank  too  much  was 
guilty  of  conduct  most  reprehensible  to  the  philoso- 
pher,  to   the   Epicurean   especially,   in   that   the 

224 


THE  PRIME  OF  LIFE 

subsequent  condition  of  those  thus  indiscreet 
entailed  many  pangs  and  much  suffering  and 
illness.  Therefore  the  enjoyment  of  life  must  be 
temperate;  moderation  in  all  things  was  his 
dictum.  To  him  the  business  of  eating  was  a 
serious  one,  as  is  attested  by  many  a  quaint 
aphorism,  each  one  of  which  is  worthy  to  be  well 
pondered  over.     For  example: 

"But  for  life  the  universe  were  nothing;  and 
all  that  has  life  requires  nourishment."  "The 
fate  of  nations  depends  upon  how  they  are  fed." 
(It  has  been  well  observed,  by  the  way,  that  it 
was  not  slavery  nor  states'  rights  which  brought 
on  the  Civil  War,  but  the  frying  pan.)  "The  man 
of  sense  and  culture  alone  understands  eating." 
"The  discovery  of  a  new  dish  does  more  for  the 
happiness  of  mankind  than  the  discovery  of  a 
new  planet."  "The  love  of  good  living  is  not 
merely  a  physical,  but  an  intellectual  and  a  moral 
quality  as  well,  almost  deserving  to  be  ranked  as  a 
virtue."  (Why  not  have  omitted  the  "almost.") 
"The  most  momentous  decisions  of  personal  and 
of  national  life  are  made  at  table."  "A  good 
dinner  is  but  little  dearer  than  a  bad  one."  "Di- 
gestion, of  all  the  bodily  functions,  has  most 
influence  on  the  morals  of  the  individual."  "One 
should  eat  slowly  and  in  minute  portions."  (We 
had  supposed  this  idea  was  original  with  Fletcher.) 
"The  great  majority  of  us  eat  and  drink  too  much." 
(Is  not  that  what  doctors  are  to-day  preaching  to 
their  patients,  as  if  it  were  a  new  thing?) 

Well  did  Balzac  term  Savarin's  book  "adorable." 
Besides  its  gracious  atmosphere  we  find  the  writing 
of  it  based  upon  the  double  object,  "to  lay  down 

225 


WHY  DIE  SO  YOUNG? 

the  fundamental  theory  of  gastronomy,  so  that 
she  will  take  her  place  among  the  sciences  in 
that  rank  to  which  she  has  an  incontestable  right"; 
and  "to  define  with  precision  what  must  be  under- 
stood by  the  love  of  good  living,  so  that  for  all 
time  that  social  quality  may  be  kept  apart  from 
gluttony  and  intemperance,  with  which  many 
have  absurdly  confounded  it."  This  genial  lover 
of  his  kind  was  probably  the  first  modern  exponent 
of  the  real  science  and  art  of  gastronomy.  There 
are  to-day  many  good  books  on  food  and  dietetics; 
and  the  magazines  are  furnishing  articles  without 
end  on  practical  cooking;  yet  none  among  them 
will  be  found  more  scientific,  more  useful  and  more 
entertaining  in  a  kindly  and  mellow  way  than  The 
Physiology  of  Taste.  If  it  were  read  more  to-day 
there  would  be  less  dyspepsia,  less  crazy  and  mean 
politics,  less  crime,  less  general  cussedness,  and  fewer 
divorces — not  to  mention  fewer  doctors'  bills. 

"What  better  teaching  is  there  than  is  here  set 
forth — that  the  education  of  the  tastes  and  the 
appetites  should  be  an  index  of  the  degree  of  any 
given  civilization.  The  man  of  good  instincts 
and  of  culture  should  know  how  to  eat  and  drink, 
to  converse  (How  nearly  a  lost  art  is  this  to-day?), 
to  appreciate  a  beautiful  landscape,  to  enjoy  the 
fragrant  flowers — in  all  things  to  deport  himself 
sanely  and  wholesomely.  Such  was  the  philosophy 
of  Savarin,  taught  in  this  book,  which  should  not 
be  lacking  in  any  cultivated  library  of  our  day. 
Just  one  more  quotation,  in  which  we  find  a  de- 
lightful picture  of  old-time  manners:  "Let  the 
number  of  guests  be  small,  that  the  conversation 
may  be  constantly  general;  of  various  occupations, 

226 


THE  PRIME  OF  LIFE 

but  analogous  tastes;  the  men  of  wit  without 
pretension,  the  women  pleasant  but  not  coquettish. 
Let  the  dishes  be  few  but  choice,  and  the  wines 
of  the  first  quality;  the  order  from  the  more 
substantial  to  the  lighter,  the  simpler  to  the  finer 
flavors.  Let  the  meal  proceed  without  hurry  or 
bustle;  the  coffee  be  hot,  the  liqueur  chosen 
with  care.  Let  the  room  to  which  the  guests 
retire  be  large  enough  for  cards,  for  those  who 
cannot  do  without  them,  while  bearing  ample 
scope  for  conversation;  the  guests  animated  with 
the  hope  of  still  further  pleasure.  Then  let  the 
tea  be  not  too  strong,  the  toast  artistically  buttered, 
the  punch  skillfully  made.  Finally,  let  nobody 
leave  before  eleven,  and  everybody  be  in  bed  by 
twelve." 

bright's  disease 

In  Bright's  disease  the  cells  of  the  kidney  which 
perform  the  all-important  function  of  excreting 
fluid  waste  of  the  body  are  inflamed,  either  acutely 
or  chronically;  and  so  doctors  speak  of  acute 
nephritis  or  acute  Bright's  and  chronic  nephritis. 
The  most  important  causes  of  the  acute  inflam- 
mation are  the  infectious  fevers,  such  as  scarlet 
fever,  measles,  and  diphtheria,  and  exposure  to 
cold  and  wet. 

The  doctor,  to  whom  must  be  referred  a  con- 
sideration of  the  symptoms  of  the  disease,  fears 
especially  delusional  insanity  (the  brain  being 
affected  by  the  poisons  retained  in  the  circulation) 
and  various  palsies.  Oftentimes  there  is  an  over- 
worked heart.  Under  appropriate  treatment  the 
patient  should  do  well. 

227 


WHY  DIE  SO  YOUNG? 

In  chronic  Bright's  disease  of  the  kidneys,  the 
functioning  cells  of  those  precious  organs  have 
been  inflamed  in  such  a  way  that  a  great  deal 
of  breaking  down  of  the  vital  kidney  tissue  takes 
place.  Most  cases  come  about  through  neglect  of  or 
by  reason  of  repeated  attacks  of  acute  nephritis. 

We  cannot,  such  is  the  nature  of  the  ailment, 
cure  Bright's  disease,  because  we  have  no  way  of 
replacing  the  kidney  tissue  which  has  undergone 
degeneration.  But  very  much  indeed  may  be 
done  by  temperate  living,  rest,  regulated  diet, 
milk,  vegetables,  and  rice  eaten  in  moderation, 
say  once  a  day,  not  altogether  excluding  meat, 
fish,  and  eggs. 

Above  all,  the  patient  must  be  safeguarded 
against  uremia.  This  is  a  grave  condition  in 
which  the  kidneys  have  temporarily  ceased  func- 
tioning at  all — have  gone  on  strike,  as  it  were,  by 
reason  of  the  abuse  they  have  been  subjected  to, 
and  of  the  unfair  strain  that  has  been  put  upon 
them.  In  the  B right' s-disease  sufferer  there  are 
premonitions  of  the  oncoming  of  uremia — dizziness, 
nausea,  indistinct  or  blurred  vision,  drowsiness, 
scanty  kidney  excretion.  The  uremic  seizure 
comes  on  with  stomach  and  intestinal  disturbances, 
shortness  of  breath,  gasping,  especially  at  night, 
dry  skin,  and  the  kind  of  breathing  known  as 
Cheyne-Stokes  respiration.  Of  course  a  doctor  has 
got  to  be  summoned  at  once  in  this  condition.  For 
the  uremia  is  likely  to  deepen  into  coma  and  death. 

DIABETES 

In  diabetes  there  is  excess  of  sugar  in  the  blood. 
In  the  chemistry  of  the  body  all  starches  become 

228 


THE  PRIME  OF  LIFE 

sugar;  therefore  we  must  in  so  far  as  possible 
limit  what  is  called  the  carbohydrate  (sugar  and 
starch)  food  intake.  Excess  of  sugar  is  not  properly 
digested  and  does  not  therefore  contribute  to  the 
upkeep  of  the  body;  it  is  eliminated  unchanged  by 
the  kidney.  Disturbances  of  the  orderly  working 
of  the  pancreas  (that  organ  which  in  animals  we 
call  the  sweetbreads),  of  the  liver,  and  of  the  nervous 
system  have  been  variously  held  responsible  for 
sugar  sickness.  In  most  cases  we  shall  find  the 
trouble  fundamental  in  a  disturbed  nervous  system, 
although  in  the  management  of  the  disorder  we 
have  to  consider  very  carefully  how  the  pancreas 
and  the  liver  are  working.  There  are  also  cases 
in  which  the  sugar  sickness  is  predisposed  to  by 
disease  or  injury  of  the  brain  or  spinal  cord,  harden- 
ing of  the  arteries,  overwork,  and  excessive  strain, 
and  by  serious  infectious  diseases,  such  as  typhoid 
fever  and  tuberculosis. 

Heredity  frequently  plays  its  part,  many  members 
of  the  same  family  in  successive  generations  being 
thus  afflicted.  Along  with  this  goes  a  family 
tendency  to  take  on  weight,  so  that  there  is  a 
history  of  " diabetogenous  obesity"  through  several 
generations.  People  of  highly  emotional  or  neu- 
rotic temperament,  either  inherited  or  acquired 
through  the  stress  and  strain  of  our  civilization — 
so  abnormal  as  it  is  in  many  respects — are  prone  to 
diabetes.  Sugar  sickness  is  commoner  in  the 
city  than  in  the  country,  by  reason,  I  am  sure, 
of  the  disorganized  effect  the  wear  and  tear  of 
the  city  life  has  on  the  nervous  system.  The 
sedentary  are  more  susceptible  than  athletes  (unless 
the  latter  have  developed  bad  hearts)  and  laborers, 
16  229 


WHY  DIE  SO  YOUNG? 

who  are  able  by  reason  of  their  muscular  ex- 
ertions to  "get  away"  with  all  their  carbohy- 
drate intake.  Gout,  "blood  disease,"  malaria,  the 
infective  fevers,  the  serious  diseases  from  which 
proper  convalescence  has  not  been  made,  direct 
injury  or  disease  of  the  spinal  cord  and  brain,  all 
often  lead  to  or  complicate  diabetes. 

Oddly  enough,  here  is  a  very  grave  and  fatal 
disease  for  the  young,  while  elderly  diabetics,  on 
the  other  hand,  although  their  kidney  excretion  is 
almost  never  sugar  free,  are  quite  likely  to  live 
along  comfortably  enough,  and  to  die  of  some 
other  disease  in  old  age,  if  they  will  but  be 
temperate,  exercising  all  the  precautions  required 
by  their  state  of  body,  and  avoiding  the  excesses 
which  people  who  think  themselves  healthy  feel 
at  liberty  to  commit.  This  disease  comes  on  very 
insidiously,  like  a  thief  in  the  night.  Indeed,  in 
many  cases  it  is  discovered  accidentally,  during  a 
medical  examination.  Here  is  another  among  a 
thousand  reasons  why  once  a  year,  at  least,  people 
should  go  to  their  doctors,  no  matter  how  well 
they  feel,  for  a  thorough  overhauling.  What  we 
most  have  to  fear  is  the  diabetes  coma,  which 
is  practically  never  recovered  from.  Most  adult 
diabetics  would  do  well  if  they  would  obey  their 
doctor's  orders.  But  it  is  a  very  considerable 
medical  experience  that  such  patients  are  hard  to 
control,  are  very  prone  to  do  as  they  please  as 
soon  as  they  get  beyond  the  doctor's  observation. 
Every  diabetic  must  be  under  a  doctor's  constant 
care.  Each  must  be  treated  according  to  his  own 
peculiar  constitution.  Worry,  excess,  great  exer- 
tion, exposure  must  in  all  cases  be  avoided.    Tea, 

230 


THE  PRIME  OF  LIFE 

coffee,  and,  indeed,  all  food  must  be  sweetened  with 
saccharin,  instead  of  sugar.  There  are  medicines 
appropriate  to  the  individual  case  which  the 
family  doctor  must  prescribe,  and  a  diabetic 
dietary  must  be  faithfully  adhered  to. 

RHEUMATISM 

We  have  all  read  about  the  farmer  who  came 
home  from  the  city  with  a  barometer  he  had 
bought  to  foretell  stormy  weather  with;  and  of 
how  his  better  nine- tenths  expostulated:  "Why, 
Hezekiah,  how  extravagant  you  are!  What  did 
the  Lord  give  you  the  rheumatiz  for?"  And  yet 
this  yarn  hints  not  at  all  at  the  real  cause  of  rheu- 
matism, but  at  only  one  of  its  predisposing  causes. 
Inclement  weather,  especially  exposure  to  cold 
and  wet,  in  the  changeable  fall  and  spring  months, 
fatigue  and  hardship,  alcoholism — these  agencies 
make  the  bodily  tissues  congenial  soil  for  the 
essential  cause,  which  is  a  specific  germ,  to  thrive 
in.  By  themselves  alone  they  could  not  bring  on 
a  rheumatism.  The  specific  cause  of  that  disease 
is  the  Streptococcus  rheumaticus  which,  pearl-shaped, 
appears  necklacelike  under  the  microscope.  Some 
ten  thousand  of  this  germ  (coccus  means  a  berry) 
would  make  a  string  (streptos)  about  an  inch 
long.  This  coccus,  implanting  itself  in  such  good 
soil  as  unhealthy  tonsils  and  upper  air  passages, 
catarrhal  middle  ears,  tooth  cavities,  or  any  other 
infection  focus,  gets  its  colonies  past  those  insecure 
portals  into  the  blood  and  lymph  channels,  and 
thence  to  the  various  joints,  the  heart  membranes 
and  musculature,  the  pericardial  sac,  the  pleura, 

231 


WHY  DIE  SO  YOUNG? 

the  lungs,  and  other  vital  but  vulnerable  organs 
and  tissues.  Thus  in  a  predisposed  system  is  the 
rheumatic  fever  set  up,  with  all  the  symptoms  of 
an  acute  and  serious  infection. 

Recovery  from  such  an  attack  leaves  the  sufferer 
far  from  unscathed.  For  the  irritative  inflam- 
mation invades  the  delicate  membranes,  the  liga- 
ments, the  smooth-faced  cartilages,  the  tendon 
attachments  of  muscles  within  the  joint,  the 
nerves  assigned  to  the  joint  in  the  bodily  economy — 
this  inflammation  congests  and  thickens  all  the 
parts  involved,  abstracts  much  of  the  lubricating 
fluids  necessary  for  the  free  and  painless  move- 
ments of  the  joints.  With  every  successive  rheu- 
matic attack  fresh  insult  is  offered,  fresh  injury 
is  superimposed,  until  the  chronic  rheumatic  has 
his  joints  in  the  irremediable  condition  of  fibrous 
and  thickened  membranes;  ossified  or  eroded 
cartilages  (much  like  iron  that  is  rusting  after  the 
enamel  has  worn  away) ;  gnarled,  deformed,  creaky 
joints,  either  grievously  limited  as  to  their  motion 
or  ankylosed — rendered  incapable  of  any  motion 
at  all;  while  the  muscles  designed  by  nature  for  the 
joint's  movements  are  atrophied  and  there  is 
agonizing  involvement  of  nerve  tissue.  Thus,  too, 
what  should  in  the  normal  be  exquisitely  smooth 
heart  valves  become  successively  incrusted  with 
the  infective  vegetation  until  the  cardiac  murmurs 
sound  like  a  miniature  flood  rushing  through  coral 
formation. 

One  victim  of  this  disease  in  its  chronic  form 
has,  in  seeking  a  cure,  suffered  many  things  of 
many  physicians,  some  "healers,"  and  not  a  few 
spas;    has  swallowed  gallons  of  advertised  "sure 

232 


THE  PRIME  OF  LIFE 

cures";  has  anointed  himself  with  any  amount  of 
embrocations,  including  those  "good  for  man 
and  beast."  This  sufferer  has  written  down  his 
experiences  in  a  book  entitled  Being  Done  Good, 
which  would  be  vastly  entertaining  (evidently  the 
writer,  who  is  obviously  no  end  of  a  "sport" 
has  intended  it  to  be  so),  if  one  did  not  discern 
between  the  lines,  in  a  way  to  engage  the  pro- 
foundest  sympathy,  the  excruciating  tortures  hi3 
illness  has  occasioned  him.  The  most  important 
lesson  here  is  to  heed  the  warning  of  the  first  acute 
attack  of  rheumatism,  especially  if  this  has  oc- 
cured  in  childhood  or  in  youth,  so  that  all  future 
attacks  may  be  avoided;  to  forestall,  indeed,  if 
possible,  any  attack  at  all.  This  may  oftentimes 
be  done  by  submitting  to  a  thorough  examina- 
tion by  one's  family  physician,  so  that  hidden  or 
obscure  foci  of  infection  may  be  located  and 
eradicated,  so  that,  more  especially,  upper  air 
passages  may  be  rendered  sound — that  is,  barren 
soil  for  the  germinal  weed  to  thrive  and  multiply 
in.  Most  important  of  all  is  an  inspection  by  the 
dentist,  so  that  such  germs  shall  find  no  habitat 
in  ulcerated  teeth  or  unhealthy  gums.  (Just 
think  of  it — only  8  per  cent  of  us  have  ever  sat  in  a 
dentist's  chair.)  What  many  thousands  of  cases 
of  rheumatism,  not  to  speak  of  other  infections, 
what  a  vast  deal  of  ill  health  generally,  will  go 
by  the  board  as  soon  as  the  ninety  two  millions  of 
us  will  see  and  follow  this  light. 

Such  is  the  way  to  deal  with  rheumatism.  For 
though  amelioration  of  symptoms  is  to  be  had, 
there  is  no  medicine  that  will  normalize  the  kind 
of  joints  we  have  considered,  there  is  no  human 

233 


WHY  DIE  SO  YOUNG? 

power  that  will  restore  to  heart  valves  thus  affected 
their  pristine,  supervelvety  smoothness. 

FUNCTIONAL  HEART  DISTURBANCES 

Without  any  real  organic  disease,  such  as  would 
involve  the  heart  muscle  or  the  heart  valves, 
there  are  various  functional  disturbances  which 
give  great  anxiety.  Such  disturbances  are  in 
themselves  seldom  fatal,  although  the  fright  to 
which  they  have  given  rise  has  in  some  cases 
resulted  calamitously.  There  are  various  altera- 
tions, either  temporary  or  habitual,  in  the  heart- 
beat as  to  its  volume,  its  force  or  its  time.  A  beat 
may  here  and  there  be  dropped;  there  may  be 
two  or  three  beats  in  rapid  succession,  followed 
by  a  pause;  or  there  is  the  gallop  rhythm,  which 
resembles  the  footfalls  of  a  cantering  horse;  or 
the  heart  beats  with  excessive  rapidity,  especially 
in  very  nervous  persons,  sometimes  as  many  as 
one  hundred  and  twenty  beats  in  the  minute. 
(The  normal  per  minute  is  about  seventy-two  in 
most  of  us.)  On  the  other  hand,  the  heart-beat 
may  be  very  slow  (Napoleon  is  said  to  have  had 
a  pulse  of  forty).  Such  alterations  may  be  due  to 
organic  brain  or  kidney  disease,  or  to  digestive 
disturbances.  Distress  about  the  heart  is  especially 
apt  to  occur  in  cases  of  dyspepsia,  when  a  good 
deal  of  gas,  developed  in  the  process  of  digesting 
sugars  and  starches,  distends  the  stomach,  causing 
"heartburn"  and  pressure  upward  of  the  distended 
stomach  against  the  heart.  Auto-intoxication — 
that  is,  the  poisoning  of  the  system  by  waste  sub- 
stances that  should  be  eliminated  by  the  kidneys, 

234 


THE  PRIME  OF  LIFE 

the  bowels  and  the  skin — creates  impure  blood, 
and  this  in  turn  reacts  upon  the  heart,  disturbing 
its  function.  The  excessive  use  of  tea,  coffee, 
alcohol,  and  tobacco  causes  heart  pain  and  distress; 
so  do  great  exertion  and  strong  emotion.  The 
use  of  headache  and  neuralgia  cures,  without  the 
doctor's  prescription,  weakens  the  heart  and  thus 
disturbs  its  orderly  working.  Blood  poverty  is  a 
potent  cause  of  functional  heart  disturbances; 
and  women  having  chlorosis  (green  sickness)  are 
apt  to  get  up  an  "anaemic  murmur"  which  may 
be  heard  several  feet  away  from  the  patient.  This 
is  one  of  those  heart  murmurs  which  happily  dis- 
appears with  the  anaemia  and  is  due  simply  to  the 
bodily  weakness  inherent  in  that  disease. 

Pain  in  the  region  of  the  heart  may  be  due  to 
intercostal  neuralgia  or  to  pleurisy.  Or  there 
may  be  neuralgia  of  the  heart  itself.  This  is 
likely  to  be  hereditary,  or  earlier  in  life  the  sufferer 
may  have  had  some  disease  that  had  the  effect  to 
disturb  the  heart  function.  Hardening  of  the 
arteries  is  here  a  prominent  cause.  Sometimes 
only  the  coronary  arteries,  the  peculiar  duty  of 
which  is  to  supply  the  heart  muscle  with  blood, 
are  hardened  or  otherwise  diseased.  Therefore 
such  a  sufferer  must  be  examined  without  fail  to 
ascertain  whether  the  trouble  is  simply  neuralgia 
or  a  real  heart  disease.  Such  breast  pang,  angina 
pectoris,  is  called  the  doctor's  disease,  because  it 
is  suffered  in  that  calling  probably  more  than  in 
any  other,  on  account,  among  other  things,  of 
their  being  aroused  from  heavy  sleep  to  go  about 
their  ministrations. 

In  most  cases  of  functional  heart  disturbance  the 

235 


WHY  DIE  SO  YOUNG? 

trouble  will  pass  away  as  soon  as  the  causative 
condition  is  remedied.  This  can  oftentimes  be 
done  by  simply  stopping  entirely,  for  a  time  at 
least,  tea,  coffee,  alcohol,  cigarettes,  or  other 
forms  of  tobacco.  For  neurotic  individuals  the 
doctor  must  prescribe  sedatives.  For  these,  with 
gastric  and  intestinal  ailments,  stomachics  are 
right;  for  the  anaemic,  tonics.  Only  by  a  doctor's 
examination  can  it  be  ascertained  whether  the 
heart  disturbance  is  functional  or  organic.  The 
ascertaining  of  the  blood  pressure,  by  means  of 
the  sphygmomanometer,  is  a  very  material  help  in 
such  examinations. 

VALVULAR   HEART  DISEASE 

Valvular  disease  of  the  heart  is  due  to  many 
and  varied  causes;  the  most  frequent  are  harden- 
ing of  the  arteries,  prolonged  and  excessive  exertion, 
alcoholism,  constitutional  disease,  a  severe  strain 
(as  in  piano  moving),  in  some  cases,  fortunately 
rare,  aneurism.  Or  there  may  have  been  an  acute 
infective  heart  inflammation,  perhaps  many  years 
before,  in  children  and  adolescents  who  have 
suffered  rheumatism,  St.  Vitus's  dance,  scarlet 
fever,  measles,  pneumonia,  or  diphtheria;  or  in 
adult  sufferers  from  erysipelas,  cancer,  gout,  dia- 
betes, tuberculosis,  and  Bright's  disease. 

I  cannot  explain  here  the  mechanical  obstruc- 
tions or  the  other  physical  ways  in  which  the 
system  suffers  by  reason  of  valvular  irregularity. 
Suffice  it  to  say  that  signs  of  the  disease  are  in 
many  cases  long  absent.  Any  such  danger  signal 
as  the  following  should  send  one  at  once  to  his 

236 


THE  PRIME  OF  LIFE 

physician.  Headache,  dizziness,  faintness,  flashes 
of  light,  shortness  of  breath,  palpitation  on  exer- 
tion, and  pain.  The  last  is  either  localized  in  the 
heart  region  or  sharp  and  radiating  to  the  neck 
or  left  arm,  rarely  to  the  right  arm.  As  time 
goes  on,  in  people  who  willfully  neglect  these 
signs  the  shortness  of  breath  becomes  worse  at 
night  (the  poor  sufferer  having  to  be  bolstered 
up),  there  is  cough,  anaemia  and  swelling  of  the 
feet  and  legs. 

Almost  all  valvular  heart  trouble  is  evidenced 
to  the  examining  doctor  by  murmurs,  which  are 
due  to  the  roughening  of  the  valvular  surfaces; 
these  murmurs  are  oftentimes  discovered  only 
accidentally,  as  in  candidates  for  life  insurance. 

The  outcome  of  valvular  heart  disease  will  vary 
in  the  widest  way,  according  to  the  general  bodily 
condition  of  the  individual  patient,  according  to 
such  previous  illnesses  as  have  led  up  to  the  heart 
ailments,  to  complicating  diseases  found  at  the 
time  of  examination,  and  to  the  peculiar  character 
of  the  valvular  trouble  in  each  case. 

In  general  we  may  say  that  little  children  do 
not  bear  heart  disease  well,  especially  when  there 
are  recurring  attacks  of  rheumatism  and  where 
the  child  is  insufficiently  nourished  or  not  properly 
supervised.  Sudden  death,  however,  is  very  rare 
among  such  child  sufferers.  Women  bear  heart 
trouble  better  than  men  because  they  lead  quieter 
and  less  strenuous  lives;  pregnancy  and  child 
bearing  should  indeed  be  avoided  when  possible, 
and  yet  these  are  not  factors  so  disturbing  as 
many  imagine.  (Here  the  wise  counsel  of  the 
family  doctor  should  be  sought — and  heeded.) 

237 


WHY  DIE  SO  YOUNG? 

Each  case  of  heart  trouble  must  be  judged  on 
its  merits.  Sudden  death  is  rare  in  such  cases; 
some  sufferers  who  have  died  thus  have  really 
succumbed  to  occasionless  fright.  We  may  enter- 
tain a  favorable  view  of  the  matter  when  the 
general  health  is  good  and  the  habits  are  temperate 
and  sensible;  when  there  is  no  special  liability 
to  rheumatic  or  catarrhal  affections;  when  the 
doctor  has,  by  frequent  examinations,  found  the 
condition  of  the  heart  valves,  though  abnormal, 
to  have  been  for  three  years  unchanged;  when 
the  heart  sounds  are  of  moderate  frequency,  and 
when  there  is  little  or  no  hardening  of  the  arteries 
(as  estimated  by  the  blood-pressure  apparatus); 
and  so  long  as  there  is  no  evidence  of  venous 
congestion  of  the  lungs,  the  liver,  or  the  kidneys. 

How  is  valvular  heart  disease  to  be  managed? 
In  all  cases  the  quiet  life,  the  avoidance  of  excite- 
ment, of  excess,  of  worry,  of  overexertion,  and  of 
overstrain  are  absolute  essentials.  High  altitudes 
are  for  most  cases  not  good;  they  make  the  heart 
labor  too  much.  Change  of  climate  and  of  scene 
are  oftentimes  most  salutary.  In  some  cases 
(but  only  by  medical  direction)  light  exercises  are 
right.  The  food  must  be  moderate  in  amount  and 
easy  of  digestion;  the  bowels  never  clogged,  nor 
must  there  ever  be  straining  at  stool.  No  tobacco, 
absolutely.  Alcohol  only  by  the  doctor's  orders. 
In  appropriate  cases  blood  letting  is  most  beneficial 
and  affords  greatest  relief.  The  matter  of  drugs 
must  be  left  entirely  in  the  doctor's  hands.  In 
many  cases  self-drugging  is  tantamount  to  com- 
mitting suicide,  for  the  valvular  lesions  to  which 
leakage  is  due  are  various.    Taking  a  heart  stimu- 

238 


THE  PRIME  OF  LIFE 

lant  for  a  lesion  that  needs  an  anodyne  remedy, 
or  vice  versa — such  proceeding  is  likely  to  result 
fatally.  In  many  cases  the  patient  is  better  off 
without  drugs  at  all;  in  other  cases  they  are 
essential. 

Every  sufferer  from  heart  disease  should  be 
under  the  constant  care  of  a  capable  doctor,  by 
whose  directions,  if  they  be  faithfully  followed,  the 
patient  will  be  likely  to  live  just  as  long  in  the 
land  as  the  most  of  his  neighbors.  By  good  manage- 
ment and  judicious  living  excellent  results  are 
confidently  to  be  expected  in  most  valvular  disease 
cases. 

THE   PACE   THAT  KILLS 

Several  years  ago  heart  disease  caused  the 
highest  number  of  deaths  in  the  metropolis — 
exceeding  in  its  record  tuberculosis.  And  such 
deaths  were  reported  from  Chicago,  Boston,  Detroit, 
Philadelphia,  and  other  great  cities  as  being 
greatly  on  the  increase. 

The  physician  may  here  well  seize  the  opportu- 
nity to  observe  that,  by  reason  of  the  stress  and 
strife  of  our  era,  coupled  with  sheer  human  per- 
versity, many  men  will  not  take  the  prolonged 
rest  imperative  for  convalescence  from  serious 
infections.  Many  such  patients  have  been  reading 
up  their  troubles  in  health  magazines,  Sunday 
supplements,  and  cyclopaedias,  and  they  guess 
that  they  know  what's  what!  Many  others  have 
learned  from  the  Lydia  Pinkham  of  the  Soul,  that 
there  is  no  such  thing  as  disease,  anyway,  since 
matter  is  nonexistent  and  the  senses  are  a  lie, 
those  of   doctors   being   especially   prevaricative. 

239 


WHY  DIE  SO  YOUNG  P 

The  doctor's  ipse  dixit  has  no  more  weight  in 
these  days  than  has  the  theologian's,  although 
never  before  in  human  history  has  the  medical 
profession  performed  such  near-miracles  and  done 
so  much  beneficent  work.  Elderly  men  are  pe- 
culiarly unmanageable,  pooh-poohing  doctors  as 
such  a  fussy,  unreasonable  lot  and  declaring, 
furthermore,  that  an  old  horse  that  once  lies 
down  never  gets  up.  One  old  man  disobediently 
left  his  bed,  considering  a  deal  he  had  on  to 
be  paramount,  went  downtown,  returned  that 
afternoon  in  collapse,  and  died  the  next  day. 
Another  man,  in  his  prime,  convalescent  from 
pneumonia,  the  toxins  of  which  disease  had  sadly 
disintegrated  his  heart  muscle,  persisted  in  exercis- 
ing his  ever-tense  psychism  by  sitting  up  in  bed 
and  playing  cards  with  his  wife;  of  a  sudden  he 
fell  back  on  his  pillow  and  died  of  a  dilated  organ 
that  had  had  no  time  or  chance  to  return  to 
"compensation." 

Unfortunately,  it  lies  but  little  in  the  physician's 
power  to  control  the  spirit  of  the  age.  His  warn- 
ings against  fast  living,  undue  indulgence  in 
meat  and  drink,  and  against  business  excesses 
conducive  to  such  nerve  breaking  as  must  inevit- 
ably wreck  the  organism  should  it  be  attacked  by 
disease,  all  too  often  go  unheeded.  His  "non- 
sense" about  apoplexy,  about  heightened  blood 
pressure  and  hardened  arteries;  his  little  joke 
about  rapid  living  leading  to  premature  dying — 
those  are  all  too  well  justified  by  the  avirile  lassi- 
tude, the  temperature  changes,  the  weak,  quick, 
intermittent  pulse,  the  breath  that  comes  with 
so  much  difficulty,  the  blue  lips  and  cold  finger 

240 


THE  PRIME  OF  LIFE 

tips,  the  gray  and  dusky  skin,  the  precordial  pain, 
and  the  distended  veins  in  the  neck — all  of  which 
are  like  to  have  but  one  sequel. 

HARDENED   ARTERIES 

The  arteries  are  the  body's  hose  pipes,  but 
instead  of  carrying  water  to  put  out  conflagration 
with,  they  supply  pure  blood  from  the  body's 
pumping  station  (the  heart)  for  the  sustenance 
of  the  living  tissues. 

Many  a  fire  has  been  unsuccessfully  fought,  to 
the  ruination  of  much  property,  by  reason  of 
the  hose  pipes  having  become  frayed,  ripping 
when  put  to  use.  Many  a  human  tenement  has 
gone  to  pieces  by  reason  of  the  body's  hose  pipes, 
the  arteries,  having  become  hardened,  "clay- 
piped,"  beaded  here  and  there  in  their  courses, 
rigid  but  brittle  and  fragile  tubes.  The  human 
artery  has  normally  a  good  deal  of  "give,"  to  it. 
With  each  heart  pumping  the  artery  expands  some, 
so  as  to  equalize  the  pressure,  as  anyone  can 
realize  by  feeling  the  pulse  at  the  wrist. 

Of  recent  years  there  was  a  good  deal  of  talk 
about  a  man  being  as  old  as  his  arteries.  A  man 
with  brittle  arteries  would  be  old  at  forty;  a 
man  with  good,  well-preserved,  capable  hose  pipes 
would  be  young  at  seventy.  However,  it  has  been 
found  that  in  arteries,  as  well  as  elsewhere  in 
human  bodies,  as  in  nature  generally,  the  law  of 
compensation  obtains;  that  there  are  factors  of 
safety  for  arteries,  as  well  as  for  lungs,  kidneys, 
and  nervous  systems,  and  other  tissues.  The 
meaning  of  this  is  that  anybody  with  a  moderate 

241 


WHY  DIE  SO  YOUNG? 

degree  of  arteriosclerosis  may,  if  he  be  but 
temperate,  eschew  certain  bad  habits  he  may 
have,  and  observe  given  precautions,  get  on  com- 
fortably enough  as  long  as  the  rest  of  us  are 
likely  to. 

The  onset  of  arterio-sclerosis  depends,  in  the 
beginning,  on  the  quality  of  the  arterial  tissue,  of 
vital  rubber  in  the  individual  human  machine, 
and  then  on  the  amount  of  wear  and  tear  that 
vital  rubber  has  been  subjected  to.  The  proof 
that  the  quality  of  the  vital  rubber  counts  is  that 
arterio-sclerosis  may  be  well  developed  in  a  man 
of  thirty  in  whom  there  have  been  none  of  the 
causative  factors  we  shall  presently  mention — who 
may,  indeed,  have  the  arteries  of  a  man  of  three- 
score. Entire  families  show  this  early  tendency  to 
hardening  of  the  arteries. 

Most  such  sclerosis  comes,  however,  from  bad 
use  of  good  vessels.  Here  alcohol,  tobacco,  rheu- 
matism, gout,  and  diabetes  have  their  baneful 
innings.  Lead  poisoning  in  the  trades  where  this 
metal  is  used  vitiates  the  quality  of  this  vital 
rubber.  And  then  there  are  poisonous — the  toxic — 
effects  of  the  various  infections — typhoid  fever, 
tuberculosis,  and  the  like.  "Blood  disease,"  both 
early  and  late,  work  dreadful  degenerative  changes 
in  the  arterial  vessels,  especially  in  the  aorta,  the 
largest  of  the  arteries,  and  that  into  which  the 
heart,  through  the  aortic  valves,  immediately 
pumps  its  blood. 

And  then  there  is  overeating — in  many  cases 
nothing  else  brings  on  arterio-sclerosis.  It  has  been 
well  said,  indeed,  that  in  this  disease  the  cause  is 
apt  to   lie  in   the  poisoning   due  to   undigested 

242 


THE  PRIME  OF  LIFE 

material  in  the  digestive  canal;  the  evidence  of 
this  poisoning  (toxemia)  lies  in  the  high  arterial 
tension  which  soon  becomes  evident  in  overworked 
and  degenerated  vital  rubber;  while  time  only  is 
necessary  for  change  in  the  kidneys  to  take  place 
indicative  of  the  arterio-sclerosis  that  becomes 
generalized  in  the  system.  "The  origin  is  alimen- 
tary; the  lesion  is  arterial;  the  danger  is  renal." 
Nor  is  arterio-sclerosis  uncommon  in  athletes,  in 
men  who  at  college  have  made  their  records, 
where  muscular  overexertion  has,  by  increasing 
resistance,  raised  the  blood  pressure  unduly. 

Then  there  are  the  so  often  stress  and  strain,  the 
hurry  and  worry,  the  maddening  social  and  eco- 
nomic conflicts  of  modern  life.  So  there  are 
women  at  fifty  who  have  had  none  of  the  pre- 
disposing diseases  or  other  factors  we  have  men- 
tioned, who  have  eaten  and  drunk  temperately 
enough.  And  yet  they  have  arterio-sclerosis  by 
reason  of  their  high-pressure  life. 

So  it  is  that  people  with  beginning  arterio- 
sclerosis easily  become  pallid,  or  short  of  breath,  or 
oppressed,  or  have  dyspeptic  symptoms,  or  the 
heart  begins  to  palpitate  on  exertion  or  otherwise 
to  give  evidence  of  its  presence  in  the  body — 
which  should  not  be.  For  an  organ  that  makes  its 
presence  felt  in  the  body  is  not  acting  properly. 
All  this  should  naturally  indicate  the  imperative 
occasion  of  a  medical  examination. 

The  nervous  danger  signals,  especially  of  the 
brain,  are  varied  and  always  important  to  pay 
respect  to.  There  is  retinal  sclerosis,  by  reasou 
of  which  the  sight  becomes  impaired;  there  is 
aphasia,  perhaps  occasional  and  transient,  loss  of 

243 


WHY  DIE  SO  YOUNG? 

memory,  or  dizziness  (syncope),  ringing  in  the  ears; 
there  are  various  paralyses,  which  may  not  last 
beyond  twenty-four  hours,  be  recovered  from 
perfectly,  but  very  likely  recur.  Thus  in  the 
course  of  a  couple  of  years  there  may  be  a  dozen 
such  nervous  manifestations.  But  most  of  all  to 
be  feared,  after  some  sudden  excitement  or  exertion 
or  digestive  disturbance,  is  apoplexy — that  is,  the 
fracture,  the  breaking  of  a  brittle  artery,  and  the 
resulting  hemorrhage  and  clotting  of  blood  in  the 
brain  substance. 

It  is  obvious,  from  what  we  have  observed,  that 
examination  of  the  kidney  excretion  is  a  most 
important  index  to  the  presence  of  the  degree  of 
arterio-sclerosis.  Other  grave  events  are  gangrene 
of  the  extremities.  There  is  also  much  pain  and 
loss  of  function  in  and  above  the  foot  and  ankle 
by  reason  of  hardened  vessels  in  the  leg — pain 
that  has  all  too  often  been  attributed  to  rheu- 
matism or  to  flat  foot;  there  is  here  also  much 
intermittent  lameness.  There  is  also  apt  to  be 
muscular  weakness  after  exertion,  or  complete 
disability;  numbness,  tightness,  tingling,  or  a 
feeling  as  if  ants  were  traversing  the  skin,  in  the 
arms. 

Immediately,  then,  there  is  the  slightest  indi- 
cation of  arterio-sclerosis,  or  indeed  of  any  occasion 
to  foresee  its  approach,  we  guard  ourselves  by 
living  the  quiet,  well-regulated  life,  avoiding 
especially  excesses  in  food  and  drink.  Particular 
attention  is  paid  to  the  right  functioning  of  the 
digestive  tract,  of  the  kidneys,  and  of  the  skin. 
Alcohol  is  cut  out;  tobacco  were  best  omitted; 
the  food  is  plain  and  wholesome — largely  vegetable. 

244 


THE  PRIME  OF  LIFE 

The  Chittenden  dietary  I  have  mentioned  is 
ample  enough  for  any  arterio-sclerosis  sufferer. 
Much  water  is  drunk.  Vacations  and  change  of 
scene  are  taken  by  those  who  can  afford  them. 
The  best  thing  is  to  live  in  general  the  physiological 
life.  The  effects  of  the  various  diseases  and  un- 
toward organic  conditions  mentioned  are  in  so  far 
as  possible  eliminated.  Perhaps  the  most  pertinent 
observation  in  the  premises  was  made  by  the 
physician  Cheyne  long  before  the  disease  arterio- 
sclerosis assumed  its  present  dignity:  "Every  wise 
man  after  fifty  ought  to  begin  to  lessen  the  quan- 
tity of  his  aliment;  and  if  he  would  be  free  of  great 
and  dangerous  distempers,  and  preserve  his  faculties 
clear  to  the  last,  he  ought  every  seven  years  to  go 
on  abating  gradually  and  sensibly,  and  at  last 
descend  out  of  life  as  he  ascended  into  it,  even  into 
the  child's  diet." 

EXERCISE   FOR   THE   MIDDLE   AGED 

Some  form  of  exercise  is  good  for  those  after 
forty,  especially  for  the  sedentary.  The  more 
violent  exercises  of  youth  are  for  most  of  us  in- 
appropriate to  life's  prime.  The  system  of  exer- 
cises devised  by  Walter  Camp,  the  former  Yale 
coach,  are  most  valuable  and  best  calculated  to 
restore  the  electric  juice  to  the  middle-age  life 
period.  Mr.  Camp  considers  that  "nature  never 
intended  a  man  to  be  old  at  thirty,  fat  at  forty, 
and  dependent  at  fifty  on  a  trolley  or  a  flivver  if 
he  had  to  go  a  mile."  His  system  takes  into  ac- 
count the  proposition  that  a  jaded  man  is  of 
little  use  either  to  himself  or  to  his  community; 

17  215 


WHY  DIE  SO  YOUNG? 

that  he  is  a  weak  link  in  the  universal  scheme, 
and  to  that  extent  hampers  the  whole;  that  the 
work  of  the  factory  operative,  the  clerk,  the 
executive,  the  salesman,  the  enterpriser,  and  the 
statesman  is  top  notch  only  when  his  physical 
condition  is  right. 

Most  systems  of  what  may  be  called,  as  apart 
from  golf,  sailing,  walking,  and  the  like,  artificial 
exercise,  are  tried  for  a  brief  period  and  then 
abandoned  because  the  procedures  have  occupied 
too  much  time;  or  the  result  has  been  not  re- 
freshing, but  only  fatiguing;  or  such  muscles 
have  been  strained  as  get  all  the  exercise  in  one's 
ordinary  vocation;  or  in  any  one  method  too  much 
stress  has  been  laid  on  increase  in  the  size  of 
muscles  or  on  the  development  of  "stunts" 
which  can  have  no  practical  value  to  any  man 
past  forty. 

In  the  Camp  system  the  only  apparatus  used 
is  the  human  machinery.  It  is  preparation  for 
the  day's  business  and  it  is  exhilatory;  at  the 
same  time  it  increases  the  strength  of  the  heart 
and  lungs  and  the  suppleness  of  the  trunk,  and 
it  tends  to  keep  at  a  superbly  high  point  those 
bodily  forces  which  are  resistant  to  disease  and 
to  premature  decay. 

Mr.  Camp's  idea,  which  he  has  so  generously 
promulgated,  is  that  one's  legs  and  arms  are  usually 
good  enough  for  his  life  work;  that  what  is  of  most 
vital  importance  to  a  man,  as  to  a  motor  car,  is 
the  engine,  the  part  that  is  "under  the  hood." 
The  heart,  the  lungs,  and  organs  generally  are 
what  really  count — they  being  right,  the  rest  of 
the  bodily  economy  can  take  care  of  itself.    Given 

246 


THE  PRIME  OF  LIFE 

true  power  within  the  torso,  we  shall  find  our 
efficiency,  our  ability  for  good  work,  and  our 
longevity  chances  enormously  developed.  Such 
is  the  root  of  the  matter.  It  appears  that  the 
Hon.  John  Q.  Tilson  of  Connecticut  several 
years  ago  warned  his  fellow  representatives  that 
too  little  attention  has  been  given  to  the  conser- 
vation of  the  nation's  maturer  men,  who  must 
direct  our  financial,  economic,  and  industrial  affairs; 
and  }ie  then  referred  to  what  Mr.  Camp  had  been 
doing  with  a  company  of  business  and  professional 
men  in  New  Haven. 

Mr.  Camp,  from  profoundly  patriotic  motives, 
became  the  head  of  the  Committee  on  Physical 
Reserve  of  the  National  Security  League;  and 
the  interested  reader  will  be  freely  supplied  with  all 
the  details  of  this  system  by  mailing  an  application 
for  the  necessary  information  to  the  league  at  19 
West  Forty-fourth  Street,  New  York  City. 

At  the  national  capital,  in  the  summer  season, 
Mr.  Camp  started  a  sixty -day  course  at  the  house 
of  Congressman  Kemp  for  the  benefit  of  Cabinet 
members,  Senators,  Representatives,  foreign  am- 
bassadors; supreme  court  judges,  all  manner  of 
secretaries,  commissioners,  department  directors, 
and  such  like.  "Everybody  was  doing  it."  Fifteen 
minutes  were  given  to  the  "dozen  daily  set  ups." 
And  at  the  end  of  the  course  Mr.  Camp  was  handed 
many  most  appreciative  bouquets.  For  instance, 
Secretary  McAdoo  said,  "The  work  has  been  of 
great  benefit  to  me  and  I  can  with  a  clear  con- 
science recommend  your  course  for  universal 
use."  Mr.  F.  A.  Delano  of  the  Federal  Reserve 
Board:    "I  have  worked  my  old  machine  pretty 

247 


WHY  DIE  SO  YOUNG? 

hard  these  thirty-two  years,  and  I  appreciate  the 
wisdom  and  the  philosophy  of  your  suggestions. 
The  summer  has  been  a  pretty  intense  period 
and  what  you  did  contributed  much  to  keeping 
me  fit  and  able  to  do  my  bit."  Secretary  Lane: 
"The  work  you  have  done  for  all  of  us  is  only  to 
be  measured  in  kilowatts  of  joyousness  and  good 
cheer.  I  hope  that  your  spirit  may  be  far-reaching 
and  that  your  apostles  may  spread  the  gospel 
throughout  the  land."  Assistant  Secretary  of 
the  Treasury  Crosby,  "You  have  organized  a 
group  here  not  only  of  men  who  are  better  for 
your  initiative,  but  who  recognize  it  and  are 
grateful  to  you."  Assistant  Secretary  of  the 
Treasury  Newton:  "Your  propaganda  ought  to 
be  extended  throughout  the  entire  country. 
America  is  wasteful,  and  her  greatest  waste  is 
in  the  sacrifice  of  strong  men  in  the  midst  of 
what  ought  to  be  their  period  of  most  useful 
achievement."  Mr.  Edwin  F.  Sweet  of  the 
Department  of  Commerce:  "I  wish  that  your 
plan  could  be  put  in  execution  in  every  bureau 
in  every  department,  in  both  Houses  of  Congress, 
and  among  the  business  men  of  every  city  in  the 
United  States.  The  habit  of  physical  exercise 
which  I  have  acquired  is  a  permanent  asset  to 
me;  we  have  all  learned  how  much  better  the 
profuse  perspiration,  the  deep  breathing,  and  the 
morning  baths  make  us  feel."  Mr.  Louis  E.  Post 
of  the  Department  of  Labor:  "I  would  not  trade 
the  experience  of  the  past  eight  weeks  at  Billy 
Kent's  on  four  mornings  of  every  week  for  any- 
thing that  I  have  experienced  nor  for  anything 
that  I  have  hoped  for,  except  the  end  of  the  war 

248 


THE  PRIME  OF  LIFE 

with  a  victory  for  democracy.  From  the  first 
I  have  felt  the  good  effects.  My  chest  has  got 
pretty  nearly  shipshape  with  reference  to  my 
stomach,  my  stride  is  swifter  and  steadier  and 
without  any  of  the  sense  of  weariness  I  used  to 
feel." 

Let  us  then  all  go  to  it,  those  of  us  who  since 
thirty  have  been  drifting  into  the  fallacy  of  the 
undistributed  middle.  Let  us  shorten  our  belts 
and  lengthen  our  longevity  probabilities.  First, 
however,  undergoing  thorough  medical  exami- 
nation to  insure  that  no  organ  would  be  over- 
trained or  otherwise  injured. 

DOES  GOD  FIX  THE  DEATH  RATE? 

I  once  heard  a  very  real  man  of  God,  a  broad- 
minded  clergyman  withal,  during  a  sermon,  pro- 
pound the  above  question.  And  he  reached  a 
decided  negative.  The  Almighty  gave  us  a  world; 
also  three  most  human  gifts — reason,  will  power, 
and  just  plain  common  sense.  And  he  expects  us, 
whom  he  put  on  this  earth,  to  become  coefficient 
at  least,  in  the  working  out  of  our  own  destinies. 
Especially  have  we  not  the  right  to  attribute  to  a 
cruel  Deity  such  premature  death  and  such  suffering 
as  are  actually  due  to  crass,  stubborn  ignorance  and 
to  wicked,  perverse  inhumanity.  Truly,  God  does 
not  fix  the  death  rate.  Who  does,  then?  Human 
kind  itself,  for  the  most  part. 

Those  theologians  aid  high  death  rates  who 
ignore  the  demonstrated  facts  of  disease  pre- 
vention; who  seek  to  perpetuate  the  mediaeval 
superstition  that  infections  are  merited  scourges 

249 


WHY  DIE  SO  YOUNG? 

from  on  high;  who  would  teach  that  the  forces 
evolving  pestilence  are  mightier  than  man  can 
hope  to  struggle  against,  too  awful  to  be  defied, 
which  it  were  impious  indeed  to  contend  with; 
that  hosts  must  succumb  when  the  Angel  of 
Death  spreads  his  wings  on  the  blast,  when  from 
a  cloud  passing  over  an  evil-minded  community 
a  retributive  hand  scatters  the  seeds  of  destruction ! 

Those  "faith  curers"  and  "divine  healers"  swell 
the  death  rate  who  would  ignore  that  most  mani- 
fest of  human  facts,  the  existence  of  disease  and  of 
suffering,  and  who  would  have  their  fellow  mortals 
close  their  eyes  to  the  tremendous  curative  possi- 
bilities in  material  measures. 

Those  politicians  swell  the  death  rate  who 
spend  many  millions  of  the  people's  money  in  the 
investigation  of  hog  cholera  and  hoof-and-mouth 
disease,  but  who  would  not  maintain  in  the  Presi- 
dent's Cabinet  a  Secretaryship  for  the  centrali- 
zation and  co-ordination  of  our  national  health 
activities.  (For  the  reason,  it  would  appear,  that 
the  interests  of  a  somewhat  nebulous  but  most 
reprehensive  "medical  trust"  would  thus  be 
furthered.) 

Venders  of  patent  medicines  and  of  "sure 
cures,"  who  fleece  their  victims  until  the  latter 
have  passed  far  beyond  the  incipient  stages  of 
their  maladies,  when  competent  physicians  could 
have  helped  them  to  a  cure — such  fakers  have  a 
heavy  responsibility  for  many  thousands,  every 
year,  of  occasionless  deaths. 

Those  profiteers  swell  the  death  rate  whose 
depredations  make  it  impossible  for  our  people 
to   procure   essential  sustenance,    wherefore   their 

250 


THE  PRIME  OF  LIFE 

bodies  become  easily  predisposed  to  disease  and  to 
epidemics;  this  is  to  be  said  also  of  those  who 
sell  "rots  and  spots,"  fowl  several  years  dead  in 
storage,  and  other  food  which  is  poisonous  to  the 
human  system. 

Housewives  and  poor  cooks  whose  culinary 
products  produce  dyspeptics  directly,  and  drunkards 
indirectly,  give  far  more  impetus  to  the  upward 
trend  of  the  death  rate  than  is  generally  imagined. 
And  mothers  who  can,  but  will  not,  nurse  their 
own  children,  and  those  other  well-meaning  mothers 
who  believe  they  are  able  to  raise  their  families 
in  defiance  of  such  "newfangled"  hygienic  notions 
as  are  expressed  in  this  book,  help  greatly  to  keep 
the  death  rate  high. 

Those  who  overwork  women  and  children  in' 
factories  have  a  dreadful  responsibility  for  holding 
the  death  rate  at  a  shamefully  high  level.  So 
also  do  those  employers  who  require  men  to  work 
at  dangerous  trades  under  intolerable  conditions, 
such  as  in  some  occupations  have  been  occasioning 
a  tuberculosis  mortality,  under  the  thirty-fifth 
year,  of  80  per  cent. 

Such  and  many  more  are  the  agencies  for  which 
we  are  to  blame,  making  for  millions  of  occasion- 
less  deaths  before  our  natural  span  is  reached. 

Dear  reader,  who  has  gone  thus  far  with  me, 
you  must  now  surely  realize  that  no  one  among  us 
can  safely  ignore  considerations  of  sanitation, 
hygiene,  and  disease  prevention  as  being  of  no 
personal  concern.  One  cannot,  as  to  these,  live 
by  oneself  alone.  We  cannot,  any  of  us,  escape 
some  personal  share  of  the  responsibility  for  fixing 
the  general  death  rate.     But  we  can  choose,  we 

251 


WHY  DIE  SO  YOUNG? 

can  make  at  least  the  selfish  choice,  of  being  on 
the  side  of  the  forces  that  are  working  to  bring 
down  the  death  rate,  instead  of  knowingly  aligning 
ourselves  with  the  forces  that  are  jacking  it  up. 
We  can,  at  any  rate,  realize  that  the  most  of  us 
die  sooner  than  we  have  any  right  or  business  to 
die;  can  so  live  as  to  forestall  by  many  years  the 
day  or  the  night  when  we  must  be  as  he  who 
"wraps  the  drapery  of  his  couch  about  him  and 
lies  down  to  pleasant  dreams." 


VI 

THREESCORE  AND  TEN 

"  The  sixth  age  shifts 
Into  the  lean  and  slippered  pantaloon, 
With  spectacles  on  nose  and  pouch  on  side; 
His  youthful  hose,  well  sav'd,  a  world  too  wide 
For  his  shrunk  shank;  and  his  big  manly  voice, 
Turning  again  toward  childish  treble,  pipes 
And  whistles  in  his  sound" 

LAGGING   SUPERFLUOUS? 

/T^OO  frequently  does  one  hear  the  elderly  say 
A  that  they  would  be  better  off  dead,  that  they 
are  only  in  the  way  of  those  who  are  doing  the 
World's  Work.  Do  such  dear  folk  ever  consider 
how  precious  to  their  families  is  their  mere  presence, 
how  much  of  benignancy  they  can  suffuse,  how 
potent  are  the  counsels  by  which  they  can  guide, 
out  of  their  own  rich  experience  of  life,  the  young, 
whose  province  lies  in  action. 

In  my  youth  I  had  the  blessed  good  fortune  to 
know  an  elderly  gentlewoman,  now  since  gone  to 
her  sure  reward.  It  would  be  difficult  to  imagine 
anybody  more  necessary  to  her  kin,  to  her  friends, 
to  the  community  in  which  she  lived.  No  family 
matter,  whether  the  engagement  of  her  grand- 
daughter or  the  starting  out  in  business  of  the  son  of 
her  niece's  husband's  second  cousin,  was  ever  con- 
cluded without  her  interest  being  solicited.     Any 

253 


WHY  DIE  SO  YOUNG? 

friend  who  had  ever  sat  at  her  table  or  had  drunk 
a  cup  of  tea  under  her  roof  might  claim  considera- 
tion almost  as  warm  as  was  shown  for  those 
actually  of  the  blood  or  who  had  married  into  it. 
And  a  made  man  was  that  tradesman  who  could 
deliver  his  goods  at  her  basement  door.  Her 
home,  I  must  be  careful  to  add,  was  in  that  Elysium 
about  Washington  Square  Park,  in  the  metropolis. 

This  dear  lady  had  high  tea  Sunday  evenings. 
And  youths  would  come  in  of  late  afternoons  and 
have  their  heart  agonies  soothed  by  her;  while 
girls  would  just  drop  in  and  be  amazed  to  find 
there  sundry  boys  whom  they  could  never  have 
imagined  would  happen  there  precisely  at  that 
time — oh  dear,  no!  The  old,  the  young,  men  and 
women,  with  little  children,  would  call,  and 
generally  would  stay  to  tea.  The  men  who  came 
seemed  to  appear  from  all  over  the  habitable 
globe.  She  was  the  widow  of  an  Englishman  who 
had  been  in  the  navy.  Wherefore  men  who  had 
traveled  much  were  to  be  seen  there.  And  cer- 
tainly no  one  of  them  who  ever  touched  at  the 
port  of  New  York  would  dream  of  missing  this 
snug  haven.  And  what  extraordinary  little  presents 
they  were  constantly  bringing;  the  house  seemed 
full  of  such — tea  made  of  real  tea  leaves  from 
China,  hideous  heathen  gods,  Japanese  ivory 
miniature  work,  amulets  from  India,  perfumes  from 
Araby,  laces  from  Ireland,  flowers  always. 

Truly  you  thought  of  Browning's  tender  bit  of 
flattery  that  "the  young  women  are  beautiful,  but 
the  old  women  are  still  more  beautiful,"  when  you 
were  in  the  presence  of  this  genial,  comforting, 
satisfying,   and    satisfied    hostess,    seated    at    the 

254 


THREE  SCORE  AND  TEN 

head  of  her  mahogany,  clad  in  simple,  amply 
draped,  soft  black  silk  with  old  lace  about  the 
neck  and  at  the  wrists,  the  dress  slightly  opened  at 
the  throat  and  filled  in  with  that  fluffy  kind  of 
stuff  which  I  understand  (mere  man  that  I  am) 
is  called  tulle,  an  old-time  brooch  (some  family 
heirloom)  pinned  to  and  resting  upon  it. 

No  cloth  on  the  mahogany  table,  of  course, 
but  superb  silver,  sparkling  cut  glass  and  wonder- 
ful chinaware,  with  a  bowl  of  flowers  in  the 
center  of  that  exquisitely  polished  wood.  The 
moral  tone  (I  think,  of  course,  only  of  the  men) 
was  jacked  up  many  a  peg  as  the  eye  wandered 
over  the  board  groaning  with  cold  roasts,  jellied 
loaves  of  chicken  or  veal,  cool  green  salad,  homemade 
preserves  and  cake,  while  one  drank  of  the  fragrant 
and  cheering  cup  of  tea  blended  with  lumpy 
yellow  cream,  poured  out  for  you  by  that  dear 
lady  from  her  antique  teapot — the  while  you  were 
conversing  with  the  fortunate  company  gathered 
there  in  the  benign  effulgence  irradiating  from  the 
head  of  the  table. 

"Lagging  superfluous  on  the  stage?"  Well, 
hardly.  All,  how  we  fortunate  ones  have  during 
the  years  since  been  missing  that  gracious  presence! 

THE  TRAGEDY   OF  DEAFNESS 

An  unfortunate  woman  was  taken  in  youth 
with  an  acute  ear  disease  which  rendered  her 
slightly  deaf.  This  condition  was  neglected  until, 
eight  years  later,  she  became  totally  deaf.  Mean- 
time she  suffered  greatly  with  headaches  and 
head  noises.  Sbe  had  given  birth  to  four  childreD 
and  had  the  entire  care  of  them,  doing  housework 

255 


WHY  DIE  SO  YOUNG? 

besides.  Two  of  these  children  died.  With  them 
all  she  had  been  up  innumerable  nights,  and  in 
the  daytime  the  efforts  to  hear  and  understand 
them  wore  her  out.  When  they  were  babies  and 
when  they  were  asleep  she  had  to  leave  her  work 
every  few  minutes  to  see  whether  they  were  crying, 
falling,  or  climbing  out  of  bed. 

Her  husband  having  died  and  her  two  girls 
going  out  to  work  for  the  day,  she  kept  the  house 
alone.  No  one  called  in  neighborly  spirit.  At 
times  she  expected  messengers,  expressmen,  dealers. 
So  she  had  to  go  and  see  whether  anyone  was 
ringing  the  bell  or  knocking  at  the  door,  hundreds 
of  times  a  day.  She  had  also  lost  all  sense  of 
smell.  WThen  she  was  busy  with  some  work  she 
had  to  run  and  see  whether  water  was  boiling 
over  or  something  was  cooking  too  fast.  Whenever 
she  turned  on  water  she  had  to  remain  at  the  tub 
or  sink  lest  she  should  forget  all  about  it,  and 
could  not  hear  the  overflowing.  "Most  deaf 
persons,"  she  wrote  me,  "must  be  forgetful.  A 
blind  person  is  not  expected  to  keep  house  alone 
and  seems  more  helpless  than  a  deaf  one.  Yet  it 
would  not  be  extremely  hard  for  a  blind  person 
to  know  whether  a  child  is  crying  or  getting  near 
an  open  window  or  the  hot  stove,  or  to  listen 
whether  anyone  is  coming  up  the  front  steps  and 
knocking  at  the  door.  Seeing,  where  one  should 
hear,  is  far  more  trying  than  hearing,  when  one 
should  see.  I  am  thought  to  be  a  very  quiet, 
contented  woman  who  does  not  think  it  dreadful 
to  be  deaf.  And  while  others  listen  to  music  (I 
have  heard  the  greatest  artists  who  performed  in 
the   'seventies)  and  to  conversation,  chatter  and 

256 


THREE  SCORE  AND  TEN 

laughter,  I  feel  as  though  I  carried  constantly  a 
humming,  buzzing  machine  behind  each  ear.    And  I 
hear  ringing,  singing,  roaring,  accompanied  by  deep 
organ  tones  besides — about  ten  noises  continually." 
Probably   no   other   infirmity   steals  on  one  so 
much  like  a  thief  in  the  night  as  does  deafness. 
Nor  is  there  any  so  irreparable  when  once  estab- 
lished.    Relief  then  is  always  possible  and  some 
arrest   of   the   affliction's   advance,   but   no   cure. 
Eyestrain  and  errors  of  refraction  manifest  them- 
selves  unmistakably,   especially   after  forty;    and 
the  presbyopes  among  us  may  get  fitted  with  the 
corrective  glasses.    On  the  other  hand,  most  people 
with  defective  hearing  give  little  heed  until  they 
realize,    by    accident,  perhaps,  that   they   cannot 
hear  the  watch  or  the  clock  tick  as  they  were 
wont  to  do,  or  until  there  is  a  roaring  in  the 
ears   or   a    dizzy    spell.      The   ear    mechanism    is 
extraordinarily   complicated    and    delicate,    pecul- 
iarly affected  by  catarrhs  of  the  nose  and  throat, 
by   inflammations   extending   to   the   middle   ear 
via  the  Eustachian  tube.     Most  chronic  deafness 
results  indeed,  from  oft-repeated  and  consecutive 
colds  in  the  head,  from  congestions  in  the  upper 
air  passages,  and  by  reason  of  the  migration  from 
the  mouth,  through  the  tube  mentioned,  of  grippe, 
pneumonia,  meningitis,  tuberculosis,  or  other  bac- 
teria.    Or  inflammation  will  close  up  that  tube, 
thus    destroying    the    equilibrium    which    ought 
naturally   to   obtain   between   the   air   inside   the 
ear  drum  and  the  air  without  the  drum  in  the 
external  ear.    Tobacco  and  alcohol  induce  and  keep 
up  catarrh,  and  thus  play  their  sinister  part  in 
deafness  production.     And  the  "motor  ear"  has 

257 


WHY  DIE  SO  YOUNG? 

become  common  by  reason  of  the  as  yet  abnormal 
speed  of  that  modern  invention  and  of  the  dust 
it  raises,  to  all  of  which  the  human  animal  is  not 
yet  inured.  And  the  thousand  and  one  noises 
which  constitute  the  Great  American  Vulgarity, 
and  without  which,  it  would  seem,  civilization 
cannot  be  maintained,  tend  to  blunt  the  hearing 
sense.  And  this  not  only  by  the  nervous  fatigue 
those  noises  induce  (which  fatigue  reacts  on  the 
auditory  nerve),  but  also  by  the  actual  mechanical 
destruction  that  the  noise  vibrations  work  on  the 
infinitely  delicate  and  labyrinthine  elements  of 
the  hearing  apparatus. 

Nor  is  it  generally  realized  how  great  a  handicap 
deafness  is  in  the  modern  struggle  for  existence — 
hard  enough  for  so  many,  even  unhandicapped  by 
any  physical  impairment,  but  very  hard  indeed 
for  the  elderly.  The  number  of  those  who  are 
becoming  deaf  is  constantly  increasing — and  that 
so  gradually  they  hardly  realize  the  progress  of 
their  affliction.  Their  efficiency  lessens  with  their 
hearing.  And  their  mental  activity  and  acumen  be- 
come progressively  diminished  because  the  acute- 
ness  and  the  sureness  of  our  mental  processes, 
of  our  perceptions  and  consequently  of  our  judg- 
ments, depend  very  largely  on  the  sensations 
conveyed  to  our  brains  via  our  sense  organs. 
Thus  the  inability  to  hear  the  human  voice  puts 
one  pathetically  at  a  disadvantage  in  intercourse 
with  one's  fellows  and  in  life's  occupations. 

VISUAL  DEFECTS 

Among  the  many  circumstances  in  modern 
civilization   tending   to   impair   human    vision   is 

258 


THREE  SCORE  AND  TEN 

improper  illumination,  either  natural  or  artificial. 
Too  intense  light  is  as  bad  as,  perhaps  worse  than, 
poor  lighting.  Eyes  are  not  merely  optical  adjuncts; 
they  are  integral  parts  of  the  body,  really  expanded 
portions  of  the  brain.  They  mutually  affect  the 
functioning  of  most  other  organs.  Inefficient  eyes 
cause  many  chronic  headaches,  much  depression 
and  bodily  fatigue,  many  indigestions,  and  a  great 
deal  of  nervousness. 

Any  organ  exercised  well  within  its  limits  tends 
to  increase  in  power  and  facility;  if  persistently 
overworked  it  becomes  progressively  unable  for 
any  work  at  all.  One  habitually  using  his  eyes 
in  strong  light  decomposes  his  "visual  purple" 
faster  than  it  can  be  regenerated.  Even  normal 
eyes  are  ruined  by  overuse,  especially  in  lowered 
general  health;  and  as  most  eyes  are  abnormal,  or 
at  least  not  perfect  as  to  visual  machinery,  many 
people  have  to  cope  not  only  with  bad  environ- 
ment and  lowered  health,  but  also  with  inherent 
optical  defects.  Because  of  the  many  and  newly 
invented  methods  of  commercial  lighting,  by  gas 
and  by  electricity,  the  composition  of  light  as  well 
as  its  intensity  has  come  to  require  serious  con- 
sideration. In  the  days  and  nights  of  oil  and 
candlelight  the  question  was  simply  one  of 
quantity,  the  quality  being  generally  soft  and 
benignant;  but  modern  lighting,  whether  gas  or 
electric,  is  often  so  intense  as  to  be  injurious. 
These  latter  means  of  illumination  contain  many 
more  of  the  violet  and  ultraviolet  rays  of  the  spec- 
trum than  our  fathers  were  accustomed  to.  Such 
rays  are  useful  in  the  treatment  of  disease  by  light 
in  radiography;    but  they  are  certainly  amiss  for 

259 


WHY  DIE  SO  YOUNG? 

illuminating  the  printed  page  or  the  object  on 
which  the  artisan  must  work.  Lights  that  can 
tan  and  sunburn  the  skin  and  perhaps  induce 
baldness  are  no  doubt  responsible  for  much  of 
the  present-day  visual  weakness.  The  effect  of 
such  illumination  on  the  deeper  optical  structures 
is  certainly  pernicious.  It  is  very  likely  that 
cataract  comes  from  this  cause  in  many  cases; 
certain  it  is  that  stokers,  glass  blowers,  and  other 
workers  in  intense  light  and  heat  are  enormously 
prone  to  this  grievous  eye  affection. 

Illumination  made  up  of  red  and  yellow  rays 
of  the  spectrum  is  best  for  visual  purposes;  and 
such  grateful  light  as  that  given  by  the  evening 
lamp  is  best  certainly  for  elderly  folk. 

i 

CATARACT 

A  cataract  is  a  change  in  the  crystalline  lens  of 
the  eye,  by  which  the  transparency  of  the  lens  is 
diminished.  The  most  frequent  form,  that  known 
as  senile  cataract,  comes  about  by  reason  of  the 
natural  predominance  of  the  mineral  over  the 
animal  constituents  in  the  lens  tissues. 

Our  bodies  are  made  up  in  varying  proportions 
of  animal  and  mineral  elements.  In  childhood 
the  animal  predominates;  the  mineral  in  the 
elderly.  And  in  many  of  us  the  eyes  do  not  escape 
the  natural  change,  wherefore  cataracts  form;  also 
there  is,  in  many  elderly  people,  the  arcus  senilis, 
the  pearly  ring  that  forms  around  and  in  front  of 
the  pupil  of  the  eye. 

Cataract  may  result  also  from  blows  upon  the 
eye,  from   certain   eye  diseases,  such  as  retinitis 

260 


THREE  SCORE  AND  TEN 

and  glaucoma,  rickets,  diabetes,  excessive  near- 
sightedness unrelieved  by  glasses,  occupations  in 
which  fumes  arise  from  the  material  worked  on. 
Many  people  understand  cataract  to  be  a  growth 
leading  to  blindness;  and  in  cases  of  complicated 
cataract,  when  there  is  also  some  other  eye  ailment, 
as  retinitis  or  glaucoma,  this  may  be  so.  But  the 
opaque  crystalline  lens,  in  most  cases,  only  excludes 
images;  and  the  operation  or  other  means  em- 
ployed by  able  eye  specialists  will  oftentimes  bring 
restoration  of  the  eyesight  at  least  in  considerable 
part,  although  accommodation  to  light  and  to 
distance,  which  is  a  part  of  the  function  of  the 
lens,  is  gone  after  the  operation. 

People  with  cataract  or  impending  cataract 
first  have  dimness  of  vision,  which  affects  objects 
in  all  directions  and  which  varies  with  the  degree 
of  illumination.  There  is  no  pain,  nor  are  there, 
with  uncomplicated  cataract,  any  subjective 
symptoms  such  as  headache.  The  cataract  may 
remain  stationary  for  a  time  or  it  will  increase 
until  the  whole  lens  is  opaque;  then  it  is  "ripe." 

The  nutrition  of  the  crystalline  lens  is  intimately 
related  to  that  of  the  whole  eyeball,  and  such 
nutrition  is  deranged  by  any  persistent  eyestrain 
or  other  cause  of  inflammation.  Cataract  is  very 
frequent  in  nearsighted — myopic — eyes  when  at 
the  same  time  there  is  inflammation  of  other  parts 
of  the  eye.  Naturally,  then,  the  avoidance  of  all 
eyestrain  (with  the  fitting  of  proper  glasses)  is 
essential.  Also  senile  cataract  is  the  more  liable 
to  form  or  to  increase  during  periods  of  impaired 
general  health.  Therefore  any  means  by  which 
health  is  preserved  will  delay  the  development  of 

18  261 


WHY  DIE  SO  YOUNG? 

cataract.  Other  alleged  cures  are  at  best  of  no  avail. 
The  physician  can  do  much  by  treating  the  compli- 
cations to  which  part  of  the  failure  of  vision  may 
be  due,  and  by  adjusting  the  glasses  that  will 
relieve  eyestrain  and  give  the  best  vision. 

Operation  is  generally  done  under  the  local 
application  of  cocaine  and  is  thus  painless.  A 
general  anaesthetic,  as  chloroform  or  ether,  is  in 
most  cases  not  indicated.  Here,  however,  as  in 
all  procedures  having  to  do  with  so  infinitely  deli- 
cate an  organ,  only  the  most  approved  attainable 
professional  skill  should  be  enlisted. 

ASTHMA 

Asthma  is  a  general  name  that  has  been  applied 
to  various  conditions  associated  with  extreme  and 
very  distressing  difficulty  of  breathing.  Thus  one 
speaks  of  cardiac  or  of  renal  or  of  hay -fever  asthma, 
because  chronic  heart  and  kidney  sufferers  are 
often  short  of  breath  and  because  hay  fever, 
which  has  its  site  mostly  in  the  nose  and  throat, 
is  characterized  by  the  same  symptoms.  We  are 
here,  however,  considering  more  especially  bronchial 
or  spasmodic  asthma. 

No  period  in  life  is  free  of  bronchial  asthma; 
but  elderly  people  are  likely  to  suffer  very  cruelly 
by  reason  of  it.  There  is  probably  no  human 
affection  of  which  the  causes  are  more  numerous 
or  peculiar  than  asthma.  Many  of  these  causes 
act  on  the  mucous  membrane  of  the  upper  air 
passages;  others  act  indirectly  through  the  blood 
and  the  nervous  system.  Some  unfortunate  people 
have  asthma  only  when  they  are  exposed  to  direct 

262 


THREE  SCORE  AND  TEN 

cause,  while  others  have  constantly  recurring 
attacks  without  any  apparent  cause.  And  it  is 
the  latter  which  require  study  in  each  individual 
case,  because  immense  relief  can  be  afforded  and 
even  cure  achieved  when  the  underlying  causative 
factor  is  discovered  and  perhaps  eradicated.  Among 
direct  causes  easily  ascertained  are  defects  in  the 
nose  and  throat — polypi,  bony  outgrowths,  de- 
flections of  the  septum,  hypertrophic  rhinitis,  ade- 
noids, enlarged  tonsils,  and  other  untoward  condi- 
tions. From  the  nostrils  down  to  the  dividing  of  the 
windpipe  into  the  two  largest  bronchial  tubes,  the 
physician  may,  by  careful  examination  find  a 
cause  the  removal  of  which  would  end  the  distress- 
ing and  sometimes  dreadful  paroxysms  of  this 
disease. 

Then  there  is  dust  of  all  kinds.  Common  street 
dust  should  never  be  examined  under  the  micro- 
scope just  after  a  meal;  the  process  is  liable  to 
induce  qualms.  One  sees  the  germs  of  tuberculosis, 
typhoid,  grippe,  bronchitis,  etc.;  in  the  field  molds, 
fungi,  bacteria,  and  many  most  offensive  and 
irritating  particles,  both  inorganic  and  organic; 
fluff  from  woolen  clothing,  the  dust  of  mills,  of 
foundries,  thrashing  floors,  bakeshops;  and  such 
material  as  is  evolved  in  offensive  trades — which, 
when  inspired  by  the  susceptible,  will  induce 
asthmatic  seizures.  Here  is  a  report  of  one 
specimen  of  city  dust:  "Plaster,  iron  rust,  stone 
dust,  cement  from  building  operations,  dust  from 
excavations  or  from  badly  constructed  tents,  ash, 
house  sweepings,  dried  garbage  blown  from  barrels 
and  cans,  chimney  soot,  and  cinder  from  industrial 
plants. 

263 


WHY  DIE  SO  YOUNG? 

Many  odors  will  produce  paroxysms  in  the 
asthmatic — odors  of  pitch,  phosphorus,  and  sulphur, 
of  chemical  vapors;  the  emanations  of  dogs,  cats,1 
horses,  hares;  the  smell  of  such  plants  as  ipecac 
and  of  flowers,  as,  perhaps,  the  rose.  Grasses  and 
the  pollen  of  plants  produce  asthma,  which  is  a 
disease  of  the  bronchial  tubes;  the  difference  is 
only  in  the  site  of  the  affection,  which  in  hay  fever 
is  the  nasal  cavity. 

Climate  plays  a  great  part  in  the  development 
of  asthma;  and  here  the  matter  is  almost  wholly 
one  of  idiosyncrasy  in  the  individual.  Extremes 
of  temperature  or  excessive  dryness  or,  on  the 
other  hand,  excessive  moisture,  may  induce  the 
seizure.  Thunderstorms  will  in  some  bring  on 
attacks.  But  as  to  climate,  we  can  fairly  well 
differentiate  two  classes  of  victims — those  who 
suffer  from  dampness  combined  with  either  heat 
or  cold;  and  those  who  are  especially  affected  by 
clear  atmospheres  in  which  there  is  not  sufficient 
change  of  air — as  in  deep  valleys  and  thick  forests. 
In  the  latter  cases  a  breeze  springing  up  will  relieve 
the  attack. 

Next  among  direct  causes  are  lung  troubles 
such  as  bronchial  inflammation  or  consumption, 
emphysema  and  spasm  of  the  midriff,  or  tumors 
in  the  lung  pressing  on  important  nerves.  For 
indirect  causes  of  asthma  the  history  of  the  illness 
has  to  be  minutely  considered.  People  who  have 
had  malaria,  whooping  cough,  and  measles  are 
likely  to  develop  asthma.  Heredity  and  family 
factors  have  been  traced  in  40  per  cent  of 
asthmatics.     The  disease  may  "run  in  families" 

1  Some  men  are  mad  when  they  do  smell  a  cat. — Shtlock. 

264 


THREE  SCORE  AND  TEN 

whose  nervous  machinery  is  characteristically  un- 
stable; other  members  of  such  families,  if  they 
have  not  asthma,  may  instead  have  migraine  or 
neuralgia,  or  neurasthenia,  or  epilepsy.  Hereditary 
and  family  tendency  may  not  manifest  itself  in 
asthma  until  late  in  life,  although  the  children 
of  asthmatics  may  give  evidence  of  asthma  during 
attacks  of  influenza  or  coryza.  In  the  gouty, 
especially  late  in  life,  asthmatic  seizures  may  alter- 
nate with  joint  affections.  Those  who  have  had 
"blood  disease"  in  youth  may  have  asthma  later 
in  life.1 

Improper  diet — sea  food,  especially — and  an  over- 
loaded stomach,  by  which  poisons  from  undigested 
material  get  into  the  blood,  are  very  prone  to 
induce  seizures.  "Nocturnal  asthma"  comes  fre- 
quently by  reason  of  late  suppers.  Constipation 
is  here  also  a  factor.  Kidney  disease  may  be 
accompanied  by  asthma,  probably  through  the 
circulation  in  the  blood  of  toxic  substances  not 
properly  disposed  of  by  the  kidneys.  Uterine  and 
ovarian  affections  in  women  may  provoke  asthmatic 
attacks.  There  is  an  intimate  relation  between 
asthma  and  such  skin  diseases  as  eczema  and  the 
hives — no  doubt  by  way  of  the  circulation. 

But,  after  all,  the  disordered  nervous  system  is 
fundamental  in  most  asthma  cases.  The  great 
nerves  affecting  respiration  are  disturbed;  and 
thus  are  brought  about  the  spasms  of  the  bronchi 
and  the  swelling  up  of  their  lining  mucous  mem- 
brane. Such  emotions  as  anger  and  fright  may 
thus  bring  about  paroxysms.     So  also   we  may 

1  "His  bones  are  full  of  the  sins  of  his  youth,  which  shall  lie  down 
with  him  in  the  dust." — Job. 

265 


WHY  DIE  SO  YOUNG? 

understand  how  asthma  may  alternate  with  or 
be  present  along  with  such  other  nervous  affections 
as  neuralgia  and  angina  (heart  cramp). 

The  outlook  is  good  enough  as  to  life  itself. 
The  sufferer  seldom  dies  in  the  asthmatic  seizure, 
however  dreadful  it  appears  to  the  affected  by- 
stander. The  question  whether  the  asthma  can 
be  cured  depends  on  whether  we  can  remove  the 
cause  or  the  causes  in  the  given  case.  The  first 
thing  that  has  to  be  done  is  to  relieve  the  seizure, 
a  matter  solely  within  the  physician's  province. 
He  will  treat  all  catarrhs  and  obstructions  of  the 
upper  air  passages,  bronchitis  and  other  complicat- 
ing affections.  He  warns  the  patient  against  dust 
and  any  odor  that  has  been  found  by  experience 
to  bring  on  seizure.  The  previous  history  is 
exhaustively  gone  into  and  every  clue  is  followed, 
sometimes  with  most  beneficent  results.  Various 
climates  may  have  to  be  tried;  one  which  is 
equable,  fairly  dry,  of  moderate  altitude,  and 
fairly  dust  free  will  be  right  in  many  cases,  but  not 
in  all.  For  many,  a  climate  of  an  opposite  sort  to 
that  in  which  the  patient  has  been  living  will 
relieve  him.  Thus,  when  the  asthmatic  has  been 
living  in  a  moist  climate  a  dry  one  may  help  him; 
the  asthmatic  whose  home  has  been  inland  may 
do  well  at  the  seashore.  Oddly  enough,  the  air  of 
cities  suits  many  sufferers  better  than  the  purer 
rural  air.  Dampness  in  air  or  soil  is  not  favorable 
generally  for  asthmatics. 

For  the  elderly  we  advise  outdoor  life,  with 
walking,  golf,  or  riding  in  moderation,  as  befits 
advancing  years.  Such  exercises  must  be  stopped 
well  within  the  point  of  fatigue.     The  open-air 

266 


THREE  SCORE  AND  TEN 

life  should  become  habitual.  The  body  surface 
must  never  be  chilled,  the  extremities  never  cold; 
tepid  baths  are  made  customary. 

The  stomach  must  never  be  overloaded;  light 
meals,  with  a  snack  between  times  if  necessary,  to 
dispel  hunger;  the  dinner  in  the  middle  of  the 
day,  to  avoid  the  nocturnal  paroxysm  Restrict, 
while  not  avoiding  entirely,  the  starches  and  the 
sugars;  banish  the  lobster,  the  crab,  and  the 
deadly  hot  bread;  plainly  cooked  and  easily 
digestible  meats,  fresh  fish,  cooked  vegetables,  and 
fruits  are  right.  The  elderly  may  take  stimulants, 
but  carefully  and  very  moderately,  if  they  be  of 
established  purity.  Coffee  is  best  taken  black, 
with  very  little  sugar.  Medication  helps  in  asthma; 
this,  however,  is  entirely  within  the  family  doctor's 
jurisdiction. 

CHRONIC   BRONCHITIS 

Many  elderly  people  suffer  from  chronic  bron- 
chitis. An  attack  of  the  grippe  or  of  acute 
bronchitis  has  been  let  to  run  on  weeks  and  months 
after  it  should  have  been  cleared  up,  and  then  the 
inflammation  of  the  "tubes"  becomes  chronic. 
The  trouble  is  apt  also  to  go  along  with  other  lung 
affections — asthma  or  consumption — heart,  artery, 
and  kidney  ailments,  alcoholism,  indigestion,  rheu- 
matism, and  gout.  Workmen  in  those  dangerous 
trades  where  they  must  constantly  breathe  in 
irritating  vapors  are  very  subject  to  chronic 
bronchitis.  After  fifty  years  this  disease  is  easily 
developed.  It  thrives  in  damp,  cold,  and  change- 
able weather.  The  sufferer  is  short  of  breath  on 
exertion,  and  he  is  easily  exhausted;   his  chest  is 

267 


WHY  DIE  SO  YOUNG? 

apt  to  feel  tight.  He  has,  however,  little  pain, 
and  rarely  fever.  His  cough  varies  with  the  state 
of  the  atmosphere  and  with  the  season;  in  the 
summer  there  may  be  none  at  all,  or  only  morning 
and  evening  cough.  The  general  health  is  then 
pretty  fair,  but  with  the  coming  of  cold  weather 
the  disease  becomes  prominent.  At  all  times 
there  will  be  in  most  cases  the  symptoms  also  of 
associated  disease. 

These  patients,  when  they  can  afford  it,  should 
spend  their  winters  in  a  dry,  warm,  equable  climate 
such  as  our  Southland  affords.  They  must,  in 
any  event  from  November  to  May,  avoid  ex- 
posure, and  at  all  times  fatigue.  The  strenuous 
life  is  not  for  them.  The  clothing,  especially  the 
footwear,  must  ever  be  warm  and  dry;  the  diet 
of  easily  digestible  food;  the  meals  regular;  the 
stomach  never  overloaded.  Such  sufferers  must 
not  take  on  fat.  The  body's  eliminative  organs 
must  receive  careful  attention.  The  physician  will 
prescribe  medicines  appropriate  to  the  individual 
case.  His  success  in  treating  this  disease  will 
depend  largely  on  his  finding  out  how  it  originated, 
and  what  diseases  (such  as  we  have  mentioned) 
accompany  the  chronic  bronchitis.  Although  com- 
plete cure  may  not  be  possible,  a  great  deal  can 
be  done  to  prevent  extension,  to  avoid  compli- 
cations, to  ease  the  symptoms,  and  to  prolong 
life. 

THE  PNEUMONIA   OF  THE  ELDERLY 

Many  elderly  people  suffer  from  the  "pneumonia 
of  the  aged.'*  The  disease  may  be  latent  and  may 
set  in  without  the  customary  chill.     The  cough 

268 


THREE  SCORE  AND  TEN 

and  the  expectoration  are  slight.  The  physician 
finds  it  difficult  to  locate  the  part  of  the  lung 
affected,  but  generally  this  is  the  most  dependent, 
the  lower  portion  of  either  lung  as  the  patient  lies 
on  his  side  or  back;  the  condition  is  then  that  of 
"hypostatic"  congestion,  or  pneumonia.  Such 
ailment  comes  about  by  reason  of  great  debility, 
with  feeble  heart  action;  and  it  is  generally  fatal. 
Many  an  apoplexy  terminates  thus. 

Pneumonia  is  indeed  one  of  the  terminal  af- 
fections such  as  are  secondary  to  other  serious 
diseases.  Especially  during  the  winter  months 
patients  with  chronic  tuberculosis  and  other 
pulmonary  diseases,  chronic  liver  troubles,  heart 
disease,  arteriosclerosis,  diabetes,  Bright's  disease, 
malaria,  typhoid  fever,  influenza — such  patients 
are  very  likely  to  be  carried  off  by  a  pneumonia 
which,  until  toward  the  end,  gives  very  little 
evidence  of  its  presence; — some  little  elevation  of 
temperature,  perhaps;  slightly  increased  and  labored 
breathing.  The  sufferer  is,  however,  so  near  the 
end  that  adequate  examination  is  not  possible 
nor  even,  indeed,  advisable.  In  diabetes  especially 
the  fatal  issue  is  determined  rather  by  pulmonary 
abscess  or  gangrene  than  by  "straight"  pneumonia. 

TERMINAL  AFFECTIONS 

It  is  an  odd  kind  of  paradox,  but  a  valid  one,  never- 
theless, that  many  people,  the  aged,  especially,  do 
not  die  of  the  disease  from  which  they  have  suffered 
most.  Secondary  or  terminal  affections  carry  off 
most  sufferers  from  incurable  maladies.  Besides 
the  terminal  pneumonia,  pleurisy  or  meningitis  or 
peritonitis  or  dysentery  have,  in  their  character  of 


WHY  DIE  SO  YOUNG? 

secondary  or  terminal  affections,  to  be  guarded 
against,  as  best  we  can,  in  the  venerable. 

APOPLEXY 

Apoplexy  is  caused  either  by  the  rupture  of  a 
blood  vessel  within  the  skull,  blood  escaping,  with 
consequent  pressure  on  the  brain;  or  by  the 
plugging  up  of  a  blood  vessel,  the  blood  supply 
to  some  part  of  the  brain  being  thus  cut  off. 

The  rupture  of  a  blood  vessel  is  predisposed  to 
by  chronic  alcoholism,  chronic  kidney  and  heart 
disease,  gout,  rheumatism,  syphilis,  and  most  of  all 
arteriosclerosis.  The  exciting  cause  of  such 
rupture  may  be  sudden  physical  exertion,  passion, 
intense  mental  perturbation,  cold-water  bathing 
in  one  unaccustomed  to  the  cold  bath,  excessive 
eating  and  drinking,  and  straining  of  any  sort. 

The  symptoms  will  vary  according  to  the  part 
of  the  brain  affected.  There  are  likely  to  be  pre- 
monitory sensations — dizziness,  fullness  or  pain  in 
the  head,  numbness  of  one  hand  or  foot,  loss  of 
memory  for  words,  bad  dreams.  The  attack  is 
sudden,  with  convulsions  and  coma;  or  there  is 
coma  alone;  or  there  is  little  or  no  loss  of  conscious- 
ness; or  the  sufferer  falls  as  if  shot  or  struck 
by  a  heavy  blow.  In  the  conscious,  speech  and 
swallowing  are  difficult.  The  tongue  is  likely  to 
protrude  toward  one  side  of  the  head;  the  mouth 
is  drawn  toward  the  sound  side  of  the  face.  The 
face  is  flushed  and  the  pupils  are  dilated;  or  one 
may  be  dilated  and  the  other  contracted.  The 
breathing  is  slow,  irregular,  and  snoring;  the 
cheeks  are  puffed  out  with  each  expiration.  The 
pulse  is  slow,  full,   and  hard.     Such  a  pathetic 

270 


THREE  SCORE  AND  TEN 

condition  may  come  on  during  sieep,  the  sufferer 
being  found  thus  in  the  morning. 

In  apoplexy  due  to  a  plugging  up  of  an  artery 
there  is  brain  softening  in  the  affected  region. 
The  plugging  is  due  either  to  an  embolus  or  a 
thrombus.  An  embolus  is  a  plug  of  vegetating 
material  detached  from  a  rheumatic  heart  valve 
or  elsewhere  and  set  coursing  along  with  the  blood 
stream.  Such  plugs  occur  in  the  infectious  fevers 
and  in  diseased  blood  states.  A  thrombus  is  a 
plug  formed  at  a  diseased  point  in  the  blood  vessel 
itself  of  sufferers  from  fatty  heart,  syphilis,  lead 
poisoning,  gout,  and  other  serious  maladies. 

When  there  is  an  embolus  the  onset  is  sudden, 
with  convulsive  twitchings.  When  there  is  a 
thrombus  there  are  like  to  be  premonitions  such 
as  we  mentioned  for  the  ruptured  vessel;  but  the 
onset  is  slow,  the  hearing  is  progressively  disturbed, 
there  are  drowsiness,  loss  of  memory,  confused 
mentality,  and  dizziness. 

Paralysis  generally  accompanies  apoplexy;  and 
this  will  vary  according  to  the  part  of  the  brain 
affected.  If  a  paralyzed  limb  is  raised  by  one's 
hand  it  will  be  found  entirely  relaxed,  flaccid,  and 
powerless.  If  the  patient  makes  any  movement 
it  will  be  by  the  hand  and  leg  of  one  side  only. 
The  face  is  usually  paralyzed  on  the  same  side  as 
the  arm  and  leg.  The  mouth  is  drawn  away  from 
the  affected  side  of  the  face,  being  pulled  thus 
by  the  unaffected  muscles. 

The  doctor  is  of  course  sent  for  at  once.  Till  he 
comes  the  most  important  measure  in  taking  care 
of  a  stroke  sufferer  is  to  disturb  him  as  little  as 
possible.     He  is  placed  in  bed  or  in  a  reclining 

271 


WHY  DIE  SO  YOUNG? 

position,  his  neck  freed  of  clothing,  his  head 
moderately  elevated,  his  shoulders  slightly  raised. 
An  ice  bag  or  cold  wet  cloths  are  placed  on  his 
head,  and  hot  bottles  to  the  extremities.  The 
latter  are  carefully  wrapped  up  in  cloths  or  towels 
so  as  not  to  blister.  Even  in  the  mildest  cases  the 
patient  remains  in  bed  a  fortnight.  The  diet  is 
light;  constipation  is  avoided,  by  enemas  if 
necessary.  The  paralyzed  limb,  if  swollen,  may 
be  wrapped  in  cotton  batting  or  flannel.  Surgeons 
have  of  late  years  done  wonders  by  trephining, 
removing  the  clot  and  thus  removing  the  pressure 
from  the  brain. 

Apoplexy  is  often  recovered  from — the  first  and 
second  strokes,  anyway;  and  chances  of  course 
diminish  with  the  patient's  age.  In  any  event, 
the  hope  of  full  recovery  from  complete  paralysis 
is  slight.  Power  is  usually  restored  in  the  leg 
sufficient  to  enable  the  patient  to  get  about,  but 
in  most  instances  the  finer  movements  of  the 
hand  are  lost.  More  or  less  mental  weakness 
may  follow  an  attack,  and  the  venerable,  thus 
recovered,  may  become  irritable  and  emotional. 
The  general  health  must  be  carefully  conserved 
and  the  emunctories  must  be  kept  active.  When 
the  paralysis  has  persisted  for  more  than  three 
months  the  patient's  relatives  must  understand 
that  the  condition  is  past  relief,  that  medicines 
and  electricity  will  not  cure,  though  they  may 
relieve  and  give  comfort. 

SLEEP 

The  disorders  and  disturbances  of  sleep  are 
sometimes  serious,  especially  in  the  elderly.    Indi- 

272 


THREE  SCORE  AND  TEN 

viduals  vary  greatly  in  the  amount  of  sleep  they 
require,  and  at  different  ages  there  are  different 
needs.  While  some  few  of  us  can  get  along  on 
less,  even  four  hours,  perhaps  the  most  of  us  need 
at  least  eight,  sometimes  ten.  There  are  also 
temperamental  differences,  and  variations  the 
result  of  habit  and  circumstances. 

Generally  speaking,  infants  sleep  most  of  the 
twenty-four  hours;  at  four  years  twelve  hours  are 
needed;  at  fourteen,  ten;  at  seventeen,  nine  and 
one-half  hours;  seven  or  eight  during  adult  life.  In 
old  age  continuous  sleep  is  rare  and  the  requirement 
is  less ;  but  frequent  naps  and  dozing  by  day  as  well 
as  by  night  maintain  a  fair  average.  More  sleep  is 
required  in  cold  than  in  temperate  or  warm  climates. 

A  cool,  dark,  quiet,  well-ventilated  room,  a 
comfortable  bed,  and  adequate  (not  excessive) 
covering  are  conducive  to  sleep.  A  preparatory 
period  of  sleepliness  is  natural,  and  in  case  of 
insomnia  ought  to  be  cultivated.  Active  emotions, 
mental  worry,  intense  thought,  cold  extremities, 
or  a  chilled  skin  defeat  the  rearrangement  of  the 
circulation  on  which  so  much  depends  for  sleep. 
No  other  physical  function  is  so  readily  disturbed. 
If  a  person  is  awakened  at  an  unusual  hour  several 
nights  in  succession,  he  tends  to  establish  a  habit 
of  awakening  at  that  hour.  Habit  is  all  powerful, 
both  for  good  and  for  evil,  here  as  generally  in  life. 
Regular  hours  for  retiring  and  arising  are  most 
important. 

The  causes  of  sleeplessness  are  many.  Reminis- 
cences occasion  much  insomnia  in  many  of  the 
elderly.  Then  does  the  sympathetic  Shakespeare 
appeal  to  them: 

273 


WHY  DIE  SO  YOUNG? 

"Sleep,  gentle  sleep, 
Nature's  soft  nurse,  how  have  I  frighted  thee, 
That  thou  no  more  wilt  weigh  mine  eyelids  down 
And  steep  my  senses  in  forgetfulness." 

Practically  every  deviation  from  health  is  marked 
by  disturbances  of  sleep;  and  once  a  bad  sleep 
habit  is  established  it  tends  to  persist  and  is  likely 
to  become  the  sufferer's  chief  ailment.  Many  people 
are  hereditarily  poor  sleepers.  Every  trivial 
sound  or  unusual  circumstance  (a  light,  an  odor, 
or  a  jar,  even  the  discontinuance  of  a  customary 
noise  or  light)  may  put  an  end  to  the  rest.  Hunger, 
overfeeding,  indigestion,  gout,  kidney  trouble, 
various  drug  addictions,  tea,  tobacco,  alcohol, 
fevers  of  all  sorts,  malaria,  lead  poisoning,  too 
much  or  too  little  blood  in  the  brain,  heart  maladies, 
discomfort,  pain,  nervous  exhaustion,  mental  pre- 
occupation, intense  study — such  are  among  the 
causes  inciting  to  sleeplessness. 

Some  people  readily  fall  asleep,  but  shortly 
awake  and  remain  so  the  balance  of  the  night, 
or  they  merely  secure  fitful  periods  of  sleep.  Others 
spend  several  hours  getting  to  sleep,  and  they 
then  rest  fairly  well.  Still  others  complain  of 
broken  sleep,  the  night  being  passed  in  alternating 
sleep  and  wakefulness,  which  may  be  quite  uniform 
in  a  given  instance.  As  a  rule  patients  suffering 
with  insomnia  are  disposed,  quite  unintentionally 
in  most  cases,  to  exaggerate  the  amount  of  their 
sleeplessness;  it  is  indeed  a  common  experience 
to  find  such  patients  sleeping  soundly  part  of  or 
even  most  of  the  night,  when  one  looks  in  to  see 
how  they  are  getting  on. 

274 


THREE  SCORE  AND  TEN 

Much  loss  of  sleep  manifests  itself  in  a  haggard, 
weary  air  and  lessened  muscular  force.  Appetite, 
digestion,  energy  in  general,  courage,  and  good 
nature  are  diminished.  The  sufferer  loses  weight 
and,  in  cases  of  absolute  deprivation  of  sleep,  the 
loss  may  equal  that  due  to  the  deprivation  of 
food.  The  eyes  of  the  insomnia  sufferer  lose  their 
clearness  and  appear  dull,  and  the  whites  of  the 
eyes  may  be  reddened.  The  tongue  is  coated  and 
the  entire  organism  is  deranged. 

If  we  are  to  manage  insomnia  properly  we  have 
to  know  in  each  case  what  are  the  untoward 
conditions  of  which  the  loss  of  sleep  is  a  mani- 
festation. If  we  can  remove  such  conditions, 
natural  sleep  will  in  most  cases  return.  All  heredi- 
tary, digestive,  autotoxic,  circulatory,  and  nervous 
factors  have  to  be  systematically  investigated. 
Nothing  must  be  omitted  in  the  scrutiny.  Very 
often  the  mode  of  living  has  to  be  corrected  before 
sleep  can  be  restored.  The  physical  state  of  the 
sufferer  has  to  be  thoroughly  improved  by  baths, 
proper  diet,  exercise,  and  the  right  hygiene. 

A  warm  bath  taken  quietly  at  bedtime  and  not 
followed  by  any  stimulating  frictions  is  effective 
in  many  cases.  Many  other  physiologic  means  of 
inducing  sleep  are  among  the  family  doctor's 
resources. 

Any  drug  that  sufficiently  masters  the  organism 
to  produce  sleep  is  a  dangerous  remedy.  No  drug 
should  be  used  except  by  the  doctor's  prescription. 
Many  well-nigh  incurable  cases  have  been  es- 
tablished by  promiscuous  drugging  to  induce 
sleep.  There  are  cases  which  will  yield  only  to 
complete  change  of  scene.     An  ocean  or  a  lake 

275 


WHY  DIE  SO  YOUNG? 

voyage  is  especially  valuable,  as  being  devoid  of 
exhausting  excitement  and  sight-seeing.  A  sojourn 
by  the  seashore  is  in  many  cases  a  wonderful 
remedy,  by  reason  of  the  monotonous  and  soothing 
sound  of  the  ocean  waves.  One  feels  the  very 
first  night,  as  did  good  Nick  Bottom,  an  exposition 
of  sleep  coming  upon  him. 

FACTORS   OF   SAFETY 

I  have  in  this  book  used  the  phrase,  factors  of 
safety.  These  are  our  reserve  forces,  which  avail 
us  in  time  of  undue  stress  and  strain,  and  which 
keep  our  bodies  in  fairly  normal  condition  despite 
the  many  chances  we  take,  despite  our  thousand- 
fold violations  of  the  obvious  and  natural  laws  of 
health,  despite  the  multitudinous  agencies  in  our 
environment  which  are  inimical  to  human  existence. 
By  reason  of  these  factors  of  safety  many  of  us  are 
able,  safely  and  pleasantly,  to  attain  our  three- 
score and  ten;  were  it  not  for  their  existence  in 
our  bodies,  very  few  indeed  among  us  could  com- 
plete the  human  span.  The  Creator  has  merci- 
fully provided  in  us  those  latent  forces.  To  under- 
stand them  aright  we  may  well  make  an  analogy 
between  the  human  machine,  the  finest  and  most 
superior  in  nature,  and  such  mechanisms  as  are 
constructed  by  the  hand  of  man. 

Compare,  to  begin  with,  the  human  body  with 
the  steam  engine.  The  former  has  to  be  fed  and 
must  get  its  supply  of  oxygen,  or  it  will  not  keep 
going — will  not  live;  and  an  engine  must  be 
properly  fired  and  the  draught  properly  regulated, 
to  the  same  end.     The  essential  difference  is,  of 

276 


THREE  SCORE  AND  TEN 

course,  that  the  human  machine  is  self-repairing, 
while  the  other  is  not. 

Consider  now  how  the  engineer  and  the  builder, 
in  constructing  engines,  bridges,  houses,  and  the 
like,  are  careful  to  calculate  and  to  allow  for  the 
margin  of  safety.  Assume,  for  instance,  that  the 
tensile  strength  of  boiler  steel  plates  and  stay 
bolts  is  60,000  pounds  to  the  square  inch;  the 
actual  working  stress  to  the  square  inch  should 
then  not  be  more  than  10,000  pounds  for  the 
plates  and  6,000  pounds  for  the  stay  bolts.  That 
is,  the  stress  to  which  the  plates  may  be  subjected 
in  the  boiler  should  be  only  one-sixth  the  actual 
strength  of  the  steel,  and  the  stay  bolts  but  one- 
tenth.  The  factors  of  safety  are  here  said  to  be 
six  for  the  plates  and  ten  for  the  bolts. 

For  many  functions  the  animal  mechanism  is 
doubled  or  even  trebled.  The  functioning  of  one 
organ  is  oftentimes  assisted  by  other  organs.  One 
may  live  with  lungs  reduced  by  disease  or  surgical 
operation  to  one-sixth  their  normal  capacity. 
From  one-half  to  three-fourths  of  the  liver  may  be 
removed  without  jeopardy  to  life — indeed,  we 
might  almost  say  to  comfortable  living.  The 
pancreas — that  organ  more  essential  to  digestion 
than  the  stomach — is  ten  times  as  large  as  is 
necessary.  Many  of  our  organs  are  bilateral — we 
really  need  but  half  of  them.  One-half  the  brain 
would  do,  has  had  to  do,  after  accidents  or  by 
reason  of  certain  diseases.  People  have  got  along, 
are  constantly  getting  along,  as  if  nothing  had 
happened,  after  the  removal  of  one  kidney.  There 
is  a  surplusage  of  bones  and  cartilage.  One  gentle- 
man during  twenty-four  operations  parted  with  a 

19  277 


WHY  DIE  SO  YOUNG? 

hand,  a  leg,  an  appendix,  an  eye,  several  bones,  and 
some  of  his  liver,  and  seems  not  to  have  been 
seriously  discommoded. 

Particularly  well  provided  with  factors  of  safety 
is  that  part  of  the  human  machine  where  our 
thinking  is  done.  The  seat  of  the  mind,  the 
brain,  is  protected  by  a  bony  casement  within 
which  is  the  most  bountiful  and  most  interrelated 
blood  supply  in  the  human  system.  We  have 
always  a  good  deal  more  blood  than  we  really 
need,  for  nearly  half  of  this  precious  fluid  can 
be  withdrawn  without  serious  consequences. 
Indeed,  there  are  diseases  in  which  losing  a  pint 
or  so  of  blood  would  be  salutary.  Within  five 
days  the  body  would  recover  the  loss.  The  active 
tissues  of  most  of  the  organs  exceed  greatly  what 
is  needed  for  the  normal  functioning  of  those 
organs.  In  some  organs  the  surplusage  is  five, 
ten,  or  even  fifteen  times  the  actual  requirements. 
Physicians  never  give  over  being  astonished  at 
post-mortem  examinations  by  the  extensive  organic 
changes  found  in  people  who  have  died  in  advanced 
years  and  who  have  manifestly  suffered  at  various 
times  in  their  lives  of  grave  diseases,  living  on, 
nevertheless,  despite  the  ravages  of  the  latter. 
And  the  psychic,  the  mental  factors  of  safety — 
what  a  suggestive  study  will  the  psychologist  find 
here! 

So  there  is  ample  scientific  warrant  for  the 
statement,  "The  half  of  his  strength  he  put  not 
forth."  Thus  can  we  understand  how  in  the  men 
whom  we  call  great  there  is  a  potential  far  beyond 
the  measure  of  their  deeds.  All  of  us,  indeed,  have 
within  ourselves  a  latent,  an  abounding  potency; 

278 


THREE  SCORE  AND  TEN 

the  resources  of  mind  and  body  we  are  able  to 
draw  on  for  supreme  occasions  are  far  beyond  our 
ken.  It  is  by  reason  of  the  amplitude  of  our 
reserve  forces,  both  physical  and  mental,  that  we 
are  able  to  preserve  ourselves  in  fairly  good 
condition,  despite  the  many  malign  agencies  en- 
vironing us — unexpected  stresses,  accidents,  the 
diseased  states  we  have  been  considering,  and  the 
far  greater  number  of  maladies  for  which  we 
have  not  been  able  in  these  pages  to  find  place. 

Philip  Gibbs,  who  did  such  epic  writing  about 
the  recent  war,  observed  with  astonishment  the 
way  in  which  the  soldier  recovered  from  the  well- 
nigh  overwhelming  fatigues  of  battle  and  from 
the  almost  breaking  strain  on  every  quivering 
nerve  during  the  kind  of  fighting  that  was  so 
dreadful  a  part  of  that  war.  Britishers,  on  the 
last  lap  of  their  rearguard  actions,  were  tired 
almost  to  death.  Yet  when  they  were  called 
upon  for  one  last  effort,  after  six  days  of  fighting 
and  marching,  they  staggered  up  to  their  work; 
but  like  men  who  had  been  chloroformed,  with 
dazed  eyes,  gray  and  drawn  faces,  speechless, 
deaf  to  the  words  spoken  to  them,  blind  to  the 
menace  about  them,  seemingly  at  the  last  gasp. 
Footsore  and  stiff-limbed  were  such  young  fighters, 
feeling  like  very  old  men. 

Yet — and  this  was  to  that  splendid  war  corre- 
spondent the  astounding  thing — after  a  few  days' 
rest  these  heroes  were  young  and  fresh  again. 
"Upon  my  faith,  it  was  almost  impossible  to 
believe  they  were  the  same  warriors,  as  they  stood 
about  in  the  evening  sunshine,  like  men  on  a  village 
green  taking  their  ease  in  times  of  peace.    Their  kilts 

279 


WHY  DIE  SO  YOUNG? 

were  dirty  and  stained,  but  they  had  washed  off  the 
dirt  of  battle,  had  shaved,  and  cleaned  their  steel 
hats,  and  the  tiredness  had  gone  out  of  their  eyes 
and  their  youth  had  come  back  to  them.'* 

Seldom,  indeed,  in  the  most  awful  of  stresses, 
are  we  left  without  a  few  ounces  of  latent  energy 
upon  which  recuperation  may  be  based.  We  have, 
indeed,  in  our  bodies,  all  of  us,  a  reserve  potency. 
Our  resources  of  mind  and  body,  for  the  most 
part  unsuspected,  and  which  we  are  able  to  draw 
on  for  supreme  occasions  and  needs,  are  far  beyond 
any  idea  we  have  of  our  capacities. 

And  who  would  dare  say  that  our  factors  of 
safety  are  only  physical  in  sort.  The  most  the 
materialist  could  claim  is  that  the  psychic  aspects 
of  our  nature  are  based  on  our  physical  make-up. 
But  all  the  phases  of  our  nature — the  physical, 
the  intellectual,  the  volitional,  the  emotional,  the 
spiritual,  are  as  interdependent  as  they  are  inter- 
related. One  may  have  in  himself  no  end  of 
physical  resources;  but  these  will  remain  impotent 
if  there  be  in  that  man  no  will,  no  religious  zeal, 
no  sense  of  outrage  that  has  to  be  resented  to 
bring  his  physical  reserves  into  action. 

The  will-to-win  is  a  most  powerful  inciter  of 
reserve  force.  I  have  a  photograph  of  a  great 
intercollegiate  boat  race,  which  shows  the  losers 
painfully  spent  at  the  end;  though  one  would 
have  expected  the  winners  to  be  the  more  ex- 
hausted, since  they  had  to  make  the  greater 
effort  to  win.  The  feeling  of  victory  is  also  salutary. 
The  mortality  from  wounds  in  a  defeated  army 
has  been  found  to  exceed  greatly  that  in  the 
army  which  has  triumphed.    Emerson  wrote: 

280 


THREE  SCORE  AND  TEN 

I  have  read  that  those  who  listened  to  Lord  Chatham  felt 
that  there  was  something  finer  in  the  man  than  anything 
which  he  said.  It  has  been  complained  of  our  brilliant  English 
historian  of  the  French  Revolution  that  when  he  has  told 
all  his  facts  about  Mirabeau  they  do  not  justify  his  estimates 
of  his  genius.  Sir  Philip  Sidney,  the  Earl  of  Essex,  Sir  Walter 
Raleigh  are  men  of  great  figure  and  of  few  deeds.  We  cannot 
find  the  smallest  part  of  the  personal  weight  of  Washington 
in  the  narrative  of  his  exploits.  The  authority  of  the  name 
of  Schiller  is  too  great  for  his  books.  This  inequality  of  the 
reputation  to  the  works  is  not  accounted  for  by  saying  that 
the  reverberation  is  longer  than  the  thunderclap;  but  some- 
what resided  in  these  men  which  begot  an  expectation  that 
outran  all  their  performance.  The  larger  part  of  their  power 
was  latent. 

Emerson  called  this  latency  character  and 
wrote  a  noble  essay  under  that  title.  And  what  the 
great  of  the  earth  possessed  superlatively  no  one 
among  us  wholly  lacks.1 

In  every  position  in  life  the  observer  must 
surely  have  discerned,  at  one  time  or  another,  the 
exhibition  of  such  reserve  stamina,  of  power 
people  have  had  but  knew  not  of,  in  themselves. 
No  day  passes  when  the  physician  has  not  found 
in  patients  individual  forces  in  reserve,  latent 
potencies  which  come  to  the  rescue  in  times  of 
undue  stress  and  strain,  and  which  serve  to  main- 
tain the  body  through  everything  of  evil  and  under 
conditions  most  antagonistic  to  health  and  well- 
being. 

Such,  and  many  more  than  we  can  here  mention, 
are  the  factors  of  safety  in  our  human  structures 
and  in  our  living  economy.    If  now,  in  addition  to 

1  The  world  is  a  riddle  to  which  the  keynote  is   character. — Dean* 

ROBBINS. 

281 


WHY  DIE  SO  YOUNG? 

those  divine  gifts  we  use,  more  than  we  have 
ever  before,  those  faculties  which  the  Almighty 
has  also  so  generously  bestowed  upon  us;  if  we 
but  understand,  more  than  ever  before,  that  we 
may,  under  divine  inspiration,  by  just  willing  it, 
become  coefficients  in  the  working  out  of  our  own 
destinies;  if  we  but  live  naturally  and  reasonably, 
temperately  applying  those  most  beneficent  princi- 
ples of  modern  hygiene,  sanitation,  and  disease 
prevention  which  have  been  so  inadequately  set 
forth  in  this  book — what,  if  we  but  do  these 
things,  is  to  prevent  the  most  of  us  from  extending 
the  kingdom  of  heaven  for  ourselves  on  this 
earth  from  threescore  and  ten  to  fivescore  and 
more?  Our  kind  does,  indeed,  rightly  belong  to 
the  centenarian  class.  Most  other  creatures  live 
to  five  times  their  periods  of  maturity.  The  genus 
homo  is  mature  at  twenty;  it  should  therefore 
live  to  one  hundred  years  at  least. 


VII 

OLD  AGE 

"Last  scene  of  all, 
That  ends  this  strange  eventful  history, 
Is  second  childhood  and  mere  oblivion, 
Sans  teeth,  sans  eyes,  sans  taste,  sans  everything." 

WHAT   DOES   IT   MEAN   TO   GROW   OLD? 

HUMANKIND'S  three  greatest  evils  are  said 
to  be  disease,  old  age,  and  death.  Disease 
certainly  is  an  evil  which  could  be  prevented  in 
most  cases  by  rational  hygiene  and  sanitation. 
Old  age  may  be  no  evil  at  all,  but  a  very  happy 
time.  And  assuming  death  to  be  an  evil,  a  propo- 
sition which  may  very  well  indeed  be  doubted, 
is  it  not  entirely  possible  for  our  kind  in  general 
to  postpone  the  meeting  of  that  evil  until  long 
after  threescore  years  and  ten? 

The  physiologist  Haller  computed  that  human 
maturity  is  attained  by  the  twentieth  year  and 
that  human  life  should  endure  five  times  that 
period.  Buffon  computed  that  in  nature  the 
average  creature's  life  duration  is  six  or  seven 
times  its  period  of  development;  that,  therefore,  a 
man's  growth  being  generally  attained  at  ado- 
lescence, his  span  of  life  should  be  fivescore  years 
rather  than  threescore  and  ten.  Buffon  also  be- 
lieved that  longevity  does  not  depend  on  habits 

2S3 


WHY  DIE  SO  YOUNG? 

of  life  or  on  modes  of  living,  but  that  long  life 
is  inherent  in  the  individual.  Anybody  can  see 
that  this  idea  does  not  apply  for  all  human  beings — 
far  from  it.  Yet  there  is  a  good  deal  in  Buffon's 
belief.  Reflect  upon  those  we  know  of  who  have 
lived  to  great  ages  despite  the  most  villainous 
habits,  despite  chronic  intoxication,  inveterate  use 
of  tobacco,  and  like  disregard  of  the  laws  of  health. 

Doctors  who  make  post-mortem  examinations 
never  cease  to  be  amazed  by  the  extensive  disease 
changes  found  in  people  who  have  died  in  advanced 
years  and  whose  bodies  give  abundant  evidence  of 
having  suffered  at  various  times  in  their  lives 
from  serious  maladies,  living  on,  nevertheless, 
despite  the  ravages  wrought  in  the  organs  and 
tissues.  Experimenters,  too,  are  amazed  to  observe 
how  our  organs  are  fortified  by  factors  of  safety 
both  as  to  function  and  as  to  structure — all  to  the 
evident  design  that  we  may  live  on  and  on,  not- 
withstanding the  thousandfold  strains  and  stresses 
to  which  we  are  constantly  subjected,  a  majority  of 
them  unnatural  as  they  occur  in  civilization. 

Metchnikoff  expressed  his  conviction  that  it 
is  very  possible  for  human  life  to  be  greatly 
lengthened.  In  maintaining  this  thesis  he  investi- 
gated not  only  the  animal,  but  also  the  vegetable 
kingdom — life,  indeed,  wherever  it  is  manifested, 
and  he  has  adduced  many  facts  in  his  two  books, 
The  Nature  of  Man  and  The  Prolongation  of  Life, 
which  go  to  show  that  existence,  in  some  of  its 
manifestations  at  least,  appears  to  be  indefinitely 
prolonged;  that  there  are  forms  of  life  which  seem 
never  to  die.  There  are  one-celled  infusoria 
which   have    a   continuous    existence,    terminable 


OLD  AGE 

only  by  violence  or  accidental  causes.  Such  a 
parent  body  lives  through  an  indefinite  series  of 
divisions,  by  which  it  is  multiplied  beyond  our 
powers  of  estimation;  it  seems  never  of  itself  to 
suffer  natural  death.  This  is  true  also  of  the 
higher  plant  forms,  some  of  which  attain  to  gigantic 
size.  The  famous  dragon  tree  which  Humboldt 
discovered  and  which  was  overthrown  by  a 
storm  was  computed  by  Metchnikoff  to  have 
lived  several  thousand  years.  Adanson,  the  French 
naturalist,  considered  that  the  baobab,  a  tree  of 
Cape  de  Verde,  was  above  five  thousand  years 
old.  We  all  know  something  of  the  great  sequoias. 
There  is,  or  there  was  until  a  few  years  ago,  a  pair 
of  tortoises  in  the  Bronx  Park  the  ages  of  which 
have  been  placed  at  three  centuries. 

One  recalls  here  the  popular  pleasantry  about  the 
camel  who  can  go  eight  days  without  a  drink,  "but 
who  wants  to  be  a  camel?"  Or  as  the  idea  occurs 
in  the  noble  fable  of  Pushkin,  the  Russian  poet : 

"How  is  it,"  asked  the  eagle  of  the  vulture, 
"that  you  live  three  hundred  years,  while  I  must 
die  at  thirty?" 

"Come  with  me,"  said  the  latter,  "and  I  will 
show  you  how  to  live  as  long  as  I."  And  they 
went  together  to  a  place  where  carrion  abounded. 
Whereat  the  eagle  concluded  he  had  rather  live  but 
thirty  years  magnificently  on  rich  red  meat  than 
three  hundred  if  to  that  end  he  had  to  eat  carrion. 

But  what  is  old  age?  What  does  it  mean  to 
grow  old?  What  goes  on  in  the  body  that  brings 
its  wearer  to  the  stage  of  the  lean  and  slippered 
pantaloon? 

We  really   do  not  know,   but  several   theories 

285 


WHY  DIE  SO  YOUNG? 

have  been  advanced.  Of  these  perhaps  but  two 
are  valid,  those  of  Metchinkoff  and  of  Nascher. 
The  former  believe  that  old  age  comes  from  slow 
self-poisoning,  from  auto-intoxication,  from  the 
body's  absorbing  gradually  through  the  months 
and  years  of  adult  life  toxic  matter,  remaining 
from  the  incomplete  elimination  of  the  bodily 
impurities.  Most  of  these  toxins  are  generated  by 
germs  which  inhabit  the  intestinal  tract.  And 
Metcbnikoff  believed  that  throughout  life  the 
emunctories,  the  eliminative  organs,  should  never 
be  clogged  up.  A  clinkered-up  human  machine 
can  never  last  as  well  as  one  that  has  had  its 
waste,  its  ashes,  as  it  were,  constantly  and  regularly 
removed. 

THE   BODY   CELLS 

Dr.  J.  L.  Nascher  of  New  York,  whose  noble 
and  peculiar  work  in  medicine  lies  in  geriatrics, 
the  science  of  the  maladies  of  old  age,  has  worked 
out  his  theory  of  cell  evolution.  The  human 
body  is  a  vast  accumulation  of  cells.  Cell  life  is 
the  origin  and  basis  of  all  our  physical  life.  And 
every  cell  comes  from  a  cell.  Existence  begins 
in  the  mother's  womb  as  one  single  cell  from 
which  future  cells  are  multiplied  and  differentiated 
for  their  several  offices  in  the  human  economy — 
nerve,  liver,  digestive,  muscle,  and  many  another 
kind  of  cell.  Thus  in  the  last  analysis  it  is  our 
cells  which  have  the  power  of  and  are  endowed 
with  the  properties  of  selection,  nutrition,  assimi- 
lation, excretion,  growth,  motion — and,  in  their 
turn,  of  reproduction.  Life  is  really  a  living  and 
a  dying  of  cells.     Our  body  to-day  is  not  quite 

286 


OLD  AGE 

our  body  of  yesterday,  for  since  yesterday  many 
of  our  cells  have  died,  and  have  been  replaced 
in  their  duties  by  others  that  have  been  evolved 
from  them.  In  the  course  of  this  constant  destruc- 
tion and  reproduction  of  cell  life  there  is  going  on 
a  constant  evolution  in  cells.  The  newer  cells  differ 
slightly  from  those  from  which  they  have  sprung. 
At  one  stage  of  the  evolution  the  cells  are  best 
adapted  to  their  surroundings,  their  environment, 
and  their  available  nutrition;  and  at  that  time 
they  are  best  fitted  to  perform  their  functions  well. 

As  life  advances,  however,  the  cells  become 
less  and  less  adapted  to  their  environment,  until, 
as  they  are  destroyed,  they  produce  other  cells 
so  little  fitted  for  the  conditions  under  which  they 
must  work  that  these  can  perform  their  functions 
practically  not  at  all.  Life,  age,  and  natural 
death  then  are  really  matters  of  cell  differentiation 
and  capacity. 

Such  is  Doctor  Nascher's  theory  of  old  age. 
And  it  appeals  to  me  very  strongly  by  reason  of 
my  belief  that,  after  all  is  said  and  done,  it  is  in 
the  last  analysis  the  soul  which  dominates  ex- 
istence. It  is  the  species  soul  which  dominates 
the  species  germ  plasm;  it  is  the  individual  soul, 
or  will,  or  mind,  or  spirit,  as  one  or  another  may 
prefer  to  call  it,  which  determines  the  course  of 
individual  life.  As  Schopenhauer  put  it,  "The 
soul  has  all  matter  to  choose  from." 

Apply  this  idea  to  Doctor  Nascher's  theory. 
We  cannot,  indeed,  estimate  by  any  instrument  or 
laboratory  method  the  influence  of  the  mind  on 
the  physical  tissues;  we  cannot  compute  the 
extent  to  which  the  will  and  thought  affect  the 

287 


WHY  DIE  SO  YOUNG? 

development  of  a  red  blood  cell,  the  evolution  of  a 
drop  of  lymph,  the  behavior  of  an  excretory  cell; 
but  it  is  every  day  and  every  hour  manifest  that 
such  physical  developments  are  affected  by  mental 
states.  It  is  surely  in  everyone's  experience  that 
mental  disturbances — as,  acute  shock  from  sudden 
grief  or  bad  news — gravely  derange  the  functions 
of  the  various  organs.  And  what  else  can  rationally 
be  expected  than  that  chronic  shock,  such  as 
through  years  accompanies  exhaustion  or  over- 
work or  anxiety,  predisposes  to  graver  affections 
in  later  life?  Will  not  a  perverse  spirit  determine 
in  time  disease  cells  in  place  of  healthy  ones? 
Will  not  a  perverted  will,  abjuring  temperance  in 
favor  of  flesh  pots,  determine  in  time  the  cells 
of  the  hobnail  liver  rather  than  such  as  would 
functionate  normally  in  old  age? 

The  ancients  had  it  that  the  sound  mind  dwells 
in  the  sound  body.  Given,  however,  the  sound 
mind,  the  mind  informed,  temperate,  cultivated, 
and  judicious,  and  as  a  matter  of  course  the 
sound  body,  enduring  to  old  age  in  ease  and 
dignity,  will  pretty  surely  develop  and  obtain. 
And  the  human  body  should  endure  to  fivescore 
rather  than  to  threescore  and  ten;  our  kind  does 
indeed  "jes'  naturally"  belong  to  the  centenarian 
class.  Most  other  creatures  live  to  five  times  their 
period  of  physical  maturity.  The  genus  homo  is 
mature  at  twenty;  it  should  thus  live  to  five 
times  twenty. 

DIETARY 

The  aged  digest  more  slowly  than  the  young; 
their  bodies  indeed  do   everything  more  slowly. 

288 


OLD  AGE 

They  should,  therefore,  not  eat  more  frequently 
than  three  times  a  day;  and,  if  hungry,  something 
light  at  bedtime.  I  was  asked  to  prepare  a  dietary 
"for  an  elderly  lady  who  finds  her  digestion  some- 
what weakened  by  advancing  years,"  and  I 
arranged  the  following,  which  may  possibly  be  of 
service  to  other  elderly  people: 

Assuming  that  there  is  no  real  disease  (for 
which  the  family  physician  must  prescribe  the 
"indicated"  dietary),  the  following  foods  should 
serve  well  and  be  comfortably  digested:  cereals, 
rice,  toast,  bread  a  day  old,  crackers,  eggs,  fish, 
nutritious  but  not  fatty  soups,  purees,  milk, 
tripe,  pork  tenderloin,  bacon,  beef,  mutton  or 
lamb  roasted  or  broiled,  game,  potatoes  (preferably 
baked),  and  most  fresh  vegetables  and  fruits 
(except  cabbage  and  bananas),  cooked.  Take 
very  moderately  peas>  lentils,  stews,  coffee,  tea, 
cocoa  and  chocolate,  goose,  duck,  beans,  sweet- 
breads. Avoid  veal,  pork,  fried  meats,  rich  pastry, 
and  anything  else  which  has  been  found  by  ex- 
perience to  disagree.  For  one's  stomach's  sake 
and,  if  one's  principles  are  not  averse,  a  glass 
or  two  a  day  of  light  wine  should  at  fourscore 
be  a  good  servant.  The  observations  of  the 
physician  Cheyne,  which  I  set  forth  with  regard 
to  arteriosclerosis,  are  pertinent  here.  If  men 
have  been  moderate  smokers  they  should  not 
have  to  give  up  these  comforts  in  old  age. 

EXERCISE   AND   WARMTH 

The  old  should  exercise  but  gently.  They 
should  walk  up  easily  graded  slopes.    They  should 

289 


WHY  DIE  SO  YOUNG? 

play  croquet  or  golf,  or  such  games  as  keep  both 
the  mind  and  the  body  pleasantly  but  not  violently 
occupied.  And  they  should  rest  often.  The 
venerable  must  ever  have  warmth;  for  them,  at 
least,  life  is  ever  a  question  of  warmth.  Their 
feet  especially  should  be  always  warm  and  dry. 

HOBBIES 

It  is  most  necessary  that  old  people  should 
have  hobbies,  which  they  should  have  begun  to 
ride  in  early  or  middle  life.  Nothing  so  ages  an 
elderly  man  who  has  laid  down  his  life's  vocation 
as  to  be  without  some  equivalent  occupation. 
There  are  many  and  most  congenial  hobbies  to 
ride.  For  example,  Gladstone  was  a  Homeric 
scholar;  Salisbury,  an  adept  in  electricity;  Joseph 
Chamberlain,  a  cultivator  of  orchids;  Billroth,  the 
great  surgeon,  a  delightful  pianist.  Of  all  hobbies, 
it  appears  to  me,  the  most  satisfying  and  the 
most  comforting  is  the  appreciation  of  music,  with, 
perhaps,  though  by  no  means  necessarily  so,  some 
little  skill  on  a  musical  instrument. 

MUSIC 

Music  is  indeed  a  most  salutary  medicine, 
because  its  component  tones  are  regular  vibrations, 
even  auditory  waves,  precisely  so  many  to  each 
note;  being  thus  unlike  cacophonies,  noises  that 
are  made  up  of  irregular  dissonant  conflicting 
vibrations.  Thus  is  the  pleasing  sense  of  perception 
of  good  music  conveyed  to  the  brain,  where  its 
benignancy  is  in  turn  transmitted  to  the  sympa- 

290 


OLD  AGE 

thetic  nervous  system,  which  directs  the  functions 
of  the  heart,  the  lungs,  the  stomach,  and  other 
organs.  Thus  is  good  music  not  only  physic  for 
the  soul,  dissipating  mental  depression,  sooth- 
ing emotional  disturbances;  but  it  also  enhances 
nutrition,  furthers  digestion  (wherefore  Voltaire 
spoke  of  "liver  music"),  quickens  the  pulse, 
helps  to  restore  organic  unity.  Indeed,  the  entire 
human  machinery  will  run  all  the  better  for  oc- 
casional lubrication  with  a  stream  of  melody  that 
is  sweetly  played  in  tune,  and  which  "will  help 
thee  in  thy  need  in  sickness,  grief,  and  all  ad- 
versities." It  is  truly  one  of  humankind's  most 
inestimable  blessings  that  into  our  stream  of 
consciousness  there  may  (be  we  so  disposed) 
empty  themselves,  most  mellifluously,  those  purling 
rivulets,  those  rippling  brooks,  those  laughing 
waters,  those  sparkling  cascades  which  have  their 
springs  in  concords  of  sweet  sound. 

A   GOOD   HABIT 

I  will  now  touch  upon  a  subject  which  I  should, 
from  a  doctor's  viewpoint,  have  considered  in  the 
beginning  of  this  book,  and  for  the  reason  that  a 
habit,  good  or  bad,  when  established  in  childhood, 
will  be  throughout  life  a  dominating  influence.  I 
am  thinking  about  the  salutary,  the  healthful 
effect,  of  the  prayer  habit,  one  which  should  be 
instilled  as  soon  as  a  child  becomes  sufficiently 
comprehending;  and  I  want  now  to  write  about 
the  physiological  effect  of  this  habit  upon  the. 
body  as  well  as  upon  the  mind  and  the  soul.  I 
reproduce   here,   as   nearly   as   I   can   remember, 

291 


WHY  DIE  SO  YOUNG? 

part  of  a  sermon  which  I  once  heard,  by  a  veritable 
man  of  God: 

"In  studying  the  biography  of  any  great  man 
we  are  very  likely  to  be  impressed  by  the  paucity 
of  his  deeds  and  sayings  by  comparison  with 
the  influence  he  has  exerted  upon  his  day  and 
generation;  we  cannot,  by  a  consideration  of  the 
former,  reach  any  just  estimate  of  that  influence. 
In  such  study  we  eventually  become  impressed 
not  so  much  by  what  the  great  man  in  the  given 
instance  did,  or  what  he  said,  but  by  what  he 
was,  his  character.  This  is  so  of  Washington,  of 
Julius  Caesar,  of  Lincoln,  of  many  another.  All 
men,  great  and  small,  do  and  say,  for  the  most 
part,  what  their  environment,  what  the  exigencies 
of  their  time,  require  of  them;  but  if  we  are  to 
discern  the  intrinsic  secret  of  the  power  which 
they  have  wielded  we  must  study  not  so  much 
their  words  and  deeds  as  their  personal  habits. 

"Jesus  Christ  preached  and  healed  the  sick 
with  altogether  peculiar  power;  but  it  is  probable 
that  his  tremendous  influence  upon  mankind 
since  his  advent  has  been  mainly  by  reason  of 
his  character.  And  to  understand  this  we  must 
study  his  personal  habits.  Conspicuous  among 
these  was  that  of  prayer.  Again  and  again,  being 
sought  in  the  intervals  of  his  benign  ministrations, 
his  disciples  found  him  in  prayer.  In  my  own 
ministry  I  have  experienced  nothing  so  fatiguing 
as  an  afternoon  spent  in  sick  calls.  I  confess  this 
leaves  me  utterly  exhausted,  and  only  in  prayer 
can  I  find  refreshment  of  body  and  soul.  I  cannot 
sufficiently  extol  medical  men  who  are  with  the 
sick  all  day  long  every  day  and  halfway  into  the 

292 


OLD  AGE 

night.  I  marvel  how  they  can  endure  the  strain. 
The  Archbishop  of  Salisbury,  in  a  talk  with  medical 
students,  advised  them,  by  way  of  relaxation  from 
their  duties,  to  cultivate  poetry.  I  know  a  better 
pursuit  than  that;  it  is  to  cultivate  the  habit  of 
prayer." 

Why  cannot  science  and  religion  collaborate  as 
to  this  habit?  The  unquestionable  trend  of  modern 
thought  is  monistic,  its  basic  concept  that  of 
a  cosmic  oneness  in  which  all  phenomena,  however 
diverse  they  may  appear,  are  most  intimately  in- 
terrelated, quite  as  is  now  unquestionably  agreed 
that  all  forms  of  energy  are  interchangeable.  I 
here  recall  three  papers  which  I  read  years  ago 
by  the  Rev.  Dr.  W.  R.  Huntington,  the  Rev. 
Dr.  Moncure  Conway,  and  the  Rev.  Dr.  Lyman 
Abbott,  all  on  the  Nature  of  Prayer.  And,  a 
layman  as  to  theology,  I  could  not  fail  to  be 
impressed  by  the  idea  fundamental  to  the  writings 
of  these  three  great  men,  each  of  a  different 
Christian  denomination — that  prayer  is  helpful 
not  so  much  as  to  the  granting  of  specific  personal 
requests;  not  so  much  in  that  the  inherently  be- 
nignant laws  of  nature  could  be  disturbed  in  their 
working  in  behalf  of  any  individual  suppliant; 
but  that  prayer  is  helpful  in  bringing  him  who 
prays  into  comfortable,  salutary,  and  restful 
relation  with  the  First  Cause,  known  variously 
to  humankind  as  the  Almighty,  as  Jehovah,  as 
"the  power  not  ourselves  making  for  righteous- 
ness," and  so  on.  (I  will  presume  here  to  interpret 
the  term  righteousness  as  meaning  Tightness, 
orderliness,  consistent  interrelation,  universal  one- 
ness; and  I  will  here  repeat,  as  being,  to  my  mind, 

20  293 


WHY  DIE  SO  YOUNG? 

pertinent,  the  definition  I  have  already  given  of 
all  morality  as  being  "the  crystallization  of  natural 
law.") 

It  must  surely  gratify  the  humanitarian  who  is 
not  of  the  clergy,  to  observe  this  departure  from 
the  theology  of  other  eras;  it  is  gratifying  es- 
pecially to  the  medical  scientist  by  reason  that 
this  modern  aspect  of  religious  faith  is  much 
in  unison  with  scientific  faith — faith  in  the  con- 
stancy of  the  universe,  in  the  invariability  and 
immutability  of  its  wholesome  laws  and  in  that 
infinite,  eternal,  and  omnipotent  influence  which 
pervades  and  controls  the  cosmos. 

Cannot,  then,  a  philosophy  of  prayer  compre- 
hensible to  all,  possible  to  be  of  reasonable  ac- 
ceptance by  all,  be  evolved,  out  of  which  could  be 
developed  a  consistent  therapeutics  of  prayer? 
Assuredly  the  human  being  needs  help  from 
without;  for,  though  a  coefficient  in  the  working 
out  of  his  own  destiny,  there  is,  when  unassisted, 
no  more  pathetically  helpless  atom  in  all  existence 
than  the  human  unit.  Surely  when  such  world- 
compellers  as  Gladstone  and  Cromwell,  Washing- 
ton, Lincoln,  and  Wilson,  and  their  like,  have 
humbly  acknowledged  and  sought  the  help  to  be 
got  out  of  prayer,  lesser  men  and  women  may  also 
seek  it,  and  that  without  humiliation.  Among 
these  latter  I  can  and  do  earnestly,  out  of  my 
experience,  indorse  the  sentiment  that  "he  who 
rises  from  his  knees  a  better  man,  his  prayer  is 
answered." 

As  I  have  before  in  these  pages  intimated, 
the  simple  fact  is  that  the  various  aspects  of 
human  nature — the  physical,  the  intellectual,  the 

294 


OLD  AGE 

volitional,  and  the  emotional — when  they  have 
been  perturbed  by  life's  stresses,  are  brought  by 
prayer  back  to  their  normal  co-ordination  and 
functioning;  that  the  prayerful  individual  by 
that  act  gets  his  relations  to  his  environment 
readjusted,  and  finds  himself  restored  to  harmony 
with  the  eternal  verities.  Such,  I  submit,  would 
be  a  reasonable  conception  of  the  act  and  the 
purpose  of  prayer,  one  which  might  well  be  set 
forth  both  from  the  pulpit  and  in  the  clinic. 

A   WELCOME   FRIEND 

There  are  some  very  comfortable  opinions  about 
old  age.  For  instance,  that  grand  old  man  of 
science  with  whose  name  I  began  this  book, 
Francis  Galton,  declared  in  his  eighty-sixth  year, 
"I  find  old  age  to  be  a  very  happy  time,  on  the 
condition  of  submitting  frankly  to  its  many  limi- 
tations." Then  there  is  "the  justified  mother  of 
men,"  whom  Walt  Whitman  extolled,  who  rests 
in  her  armchair  on  the  porch,  surrounded  by 
her  children  and  her  children's  children,  while 
the  rays  of  the  setting  sun  touch  warmly  her 
whitened  hair.  Serene  she  sits,  her  eyes  steadfast 
upon  the  westerly  glow,  as  the  twilight  gathers 
and  the  evening  star  appears,  musing  of  many 
things  in  the  past,  but  mostly  of  memorials  dearly 
treasured  and  fondly  laid  aside  in  some  old  cabinet: 

"Her  hallowed  bridal  dress, 
Her  little  dainty  gloves, 
Her  withered  flowers,  her  faded  tress." 

And  there  was  the  aged  aunt  of  Brill  at-Savarin; 
when  he  was  summoned  to  her  deathbed  he  raised 

295 


WHY  DIE  SO  YOUNG? 

her  head  and  induced  her  to  take  some  "most 
excellent  and  restorative  wine,"  whereupon  she 
thanked  him  and,  sinking  back  contentedly  on 
her  pillow,  said,  "My  dear,  should  you  come  to 
my  years  you  will  understand  that  the  aged  need 
death  just  as  the  young  need  sleep." 


APPENDIX  A 

Following  are  the  right  materials  from  which  the 
mother  may  safely  select  for  the  weaning  of  her 
child  up  to  its  fifteenth  month.  Five  meals  are 
given  daily. 

Diet  for  the  Child  from  the  Time  of  Weaning 

To  the  fifteenth  month:  Five  meals  are  given  daily. 

7  A.M.  Corn  meal,  barley,  rice,  or  wheat  jelly:  one  or  two 
tablespoonfuls  in  eight  or  ten  ounces  of  milk.  (The 
jelly  is  made  by  cooking  the  cereal  for  four  hours 
the  day  before  it  is  wanted,  and  straining  it  through 
a  colander.)    Stale  bread  and  butter  or  biscuit. 

9  a.m.   The  juice  of  one-hall  orange. 

11  a.m.  Scraped  rare  beef:  one  or  two  teaspoonfuls  mixed 
with  an  equal  quantity  of  bread  and  moistened 
with  beef  juice.  Or  a  soft-boiled  egg  mixed  with 
stale  bread  crumbs,  a  piece  of  zweiback,  and  a  half 
pint  of  milk.  (Scraped  rare  beef  is  best  obtained 
from  round  steak,  cut  thick,  and  broiled  over  a 
brisk  fire  sufficiently  to  sear  the  outside.  The 
steak  is  then  split  with  a  sharp  knife,  and  the 
pulp  scraped  from  the  fiber.) 
2.30  p.m.  Beef,  chicken,  or  mutton  broth,  with  rice  or  stale 
bread  broken  into  the  broth.  Six  ounces  of  milk, 
if  wanted.  Stale  bread  and  butter,  or  zweiback 
and  butter.  Many  children  at  the  above  age  will 
take  and  digest  apple  sauce  and  prune  pulp;  when 
these  are  given  milk  should  be  omitted. 

6  P.M.    Two  tablespoonfuls  of  cereal  jelly  in  eight  ounces 
of  milk;  a  piece  of  zweiback  and  butter.     Stale 
bread  and  butter  or  biscuit. 
297 


WHY  DIE  SO  YOUNG? 

10  p.m.    A  tablespoonful  of  cereal  jelly  in  eight  or  ten 

ounces  of  milk. 

From  fifteen  to  eighteen  months:  Four  meals  are  given  daily. 

7  a.m.  Choose  from  oatmeal,  hominy,  corn  meal,  each 
cooked  four  hours  the  day  before  they  are  used. 
When  the  cooking  is  completed  the  cereal  should 
be  of  the  consistency  of  thin  paste.  It  is  strained 
through  a  colander  and  forms,  on  cooling,  a  jelly-like 
mass.  Two  or  three  tablespoonfuls  of  this  are 
served  with  milk  and  sugar,  or  butter  and  sugar 
and  salt.    Eight  to  ten  ounces  of  milk  as  a  drink. 

9  a.m.   Toast  or  zweiback. 

11  a.m.   Choose  among  the  following  foods:    the  juice  of 

an  orange;  a  soft-boiled  egg  mixed  with  stale  bread 
crumbs  or  baked  potato;  one  tablespoonful  of 
scraped  beef  mixed  with  stale  bread  crumbs  and 
moistened  with  beef  juice;  one  tablespoonful  of 
minced  white  meat  of  chicken;  baked  potato,  a 
drink  of  milk;  zweiback  or  bran  biscuit,  or  stale 
bread  and  butter.  Sample  meal :  one  tablespoonful 
of  minced  chicken  mixed  with  baked  potato,  a 
drink  of  milk,  stale  bread  and  butter. 
2.30  p.m.  Choose  among  chicken,  beef,  or  mutton  broth  with 
rice  or  stale  bread  broken  into  it;  custard,  corn- 
starch, or  plain  rice  pudding,  junket,  stewed 
prunes  or  stewed  apples;  bran  biscuit  and  butter 
or  stale  bread  and  butter;  wheatsworth  biscuit. 

6  p.m.    Choose  among  farina,  cream  of  wheat,  wheatena, 

each  cooked  two  hours;  from  one  to  three  table- 
spoonfuls  served  with  milk  and  sugar,  or  butter 
and  sugar,  or  butter  and  salt;  drink  of  milk;  zwei- 
back, or  stale  bread  and  butter. 

From  eighteen  to  twenty -four  months:   Four  meals  are  given 
daily. 

7  a.m.   Corn  meal,  hominy,  oatmeal  with  butter  and  sugar, 

or  milk  and  sugar,  or  butter  and  salt;  a  soft-boiled 
egg  every  two  or  three  days.  Minced  chicken  on 
toast  occasionally;  a  drink  of  milk;  bran  biscuit 
and  butter,  or  stale  bread  and  butter.  When  egg 
298 


APPENDIX  A 

or  minced  chicken  are  given,  cereal  in  smaller  pro- 
portion or  cut  out. 

9  a.m.   The  juice  of  an  orange. 

11  a.m.  Rare  beef,  minced  or  scraped;  the  heart  of  a  lamb 
chop  finely  cut.  Minced  chicken,  baked  potato, 
spinach,  asparagus,  squash,  strained  or  stewed 
tomatoes,  stewed  carrots,  mashed  cauliflower;  baked 
apple  or  apple  sauce,  stewed  prunes;  stale  bread 
and  butter.  Sample  dinner:  Lamb  chop,  baked 
potato,  stewed  carrots,  baked  apple,  stale  bread, 
and  butter.  After  the  twenty-first  month  well- 
cooked  string  beans  may  be  given. 
2.30  P.M.  Chicken,  beef,  or  mutton  broth  with  rice  or  with 
stale  bread  broken  into  the  broth;  custard,  corn- 
starch, or  plain  rice  pudding,  or  junket;  bran 
biscuit  and  butter,  or  stale  bread  and  butter. 

6  P.M.  Farina,  or  cream  of  wheat  (each  cooked  two  hours) : 
from  one  to  three  tablespoonfuls  with  milk  and 
sugar,  or  butter  and  sugar,  or  butter  and  salt; 
drink  of  milk,  or  malted  milk,  or  weak  cocoa; 
zweiback,  or  stale  bread  and  butter;  wheatsworth 
biscuit. 

After  eighteen  months  many  children  will  have  better  appe- 
tite and  thrive  more  on  three  full  meals  the  day,  at  7  a.m., 
12  o'clock,  and  5.30  p.m.  At  about  3  p.m.  a  cup  of  broth  and 
a  cracker  or  toast,  or  a  drink  of  milk  may  be  given  if  it  does 
not  take  away  the  appetite  for  the  evening  meal. 

The  oatmeal,  hominy,  and  corn  meal  above  mentioned  should 
each  be  cooked  four  hours  the  day  before  they  are  used.  The 
cereal  should  then  be  of  the  consistence  of  thin  paste.  This 
is  strained  through  a  colander  and  should  form,  on  cooling,  a 
jelly-like  mass. 

During  the  second  year:  Three  square  meals,  and  a  little 
extra,  as  follows: 

Breakfast — 7  to  8  o'clock:  Oatmeal,  hominy,  cracked 
wheat  (each  cooked  four  hours  the  day  before  they  are  used) 
served  with  milk  and  sugar,  or  butter  and  sugar;  a  soft-boiled 
egg,  hashed  chicken;  stale  bread  and  butter;  bran  biscuit  and 
butter;  a  drink  of  milk. 

At  10  a.m.  the  juice  of  one  orange  may  be  given. 
299 


WHY  DIE  SO  YOUNG? 

Dinner — 12  o'clock:  Strained  soups  and  broths,  rare  beef- 
steak, rare  roast  beef,  poultry,  fish;  baked  potato,  peas,  string 
beans,  squash,  mashed  cauliflower,  mashed  peas,  strained 
stewed  tomatoes,  stewed  carrots,  spinach,  asparagus  tips; 
bread  and  butter.  For  dessert:  Plain  rice,  or  plain  bread 
pudding,  stewed  prunes,  baked  or  stewed  apple,  junket, 
custard,  or  cornstarch. 

Supper — 5.30  to  6  o'clock :  Farina,  cream  of  wheat,  wheatena 
(each  cooked  two  hours):  from  one  to  three  tablespoonfuls, 
served  with  milk  and  sugar,  or  butter  and  sugar,  or  butter 
and  salt;  a  drink  of  milk,  zweiback,  or  stale  bread  and  butter. 
Twice  a  week  custard,  cornstarch,  or  junket  may  be  given. 
Occasionally  malted  milk  or  weak  cocoa. 

With  three  meals  a  child  has  a  better  appetite,  much  better 
digestion,  and  thrives  far  better,  in  consequence,  than  those 
children  whose  stomachs  are  constantly  working  overtime. 
Yet  some  especially  delicate  children  cannot  do  without  a 
luncheon  at  3  or  3.30;  then  a  glass  of  milk  and  a  biscuit,  or  a 
cup  of  broth  and  zweiback,  are  right.  Or  a  child  may  at  this 
time  relish  instead  a  scraped  raw  apple  or  a  pear;  this  is  par- 
ticularly judicious  for  constipated  children.  Children  recover- 
ing from  serious  illness  will  require,  according  to  the  doctor's 
directions,  more  frequent  feeding. 

In  general,  good  foods  for  children  are:  Cane  sugar, 
cream,  fruit  pulp,  mashed  vegetables,  clear  soups,  pure"e  of 
vegetable,  fish,  oysters,  lamb,  veal,  gelatin,  beef,  turkey, 
mutton,  chicken,  squab,  beans,  oatmeal,  graham  flour,  Boston 
crackers,  peas,  graham  bread,  corn  meal,  wheat  bread,  barley, 
macaroni,  arrowroot,  sago,  dates,  tapioca,  molasses,  figs,  corn, 
green  peas,  spinach,  stewed  fruits,  string  beans,  onions, 
peaches,  pears,  tomatoes,  cranberries,  chocolate,  bacon  fat, 
cocoa. 

Here  are  forbidden  foods  for  the  nursery:  Ham,  sausage, 
pork,  salt  fish,  dried  beef,  corned  beef,  goose,  duck,  broiled 
or  stewed  kidneys,  liver  and  bacon,  stewed  liver,  gravies 
(except  dish  gravy),  baked  tomatoes,  pickled  beets,  fried  pota- 
toes, carrots,  pastries,  griddle  cakes,  fresh  bread,  meat  or  fruit 
pies,  rich  cakes,  hot  biscuit,  meat  stews,  raw  celery,  raw  or 
fried  onions,  radishes,  cucumbers,  muffins,  doughnuts,  pre- 
serves, canned  fruits,  tea,  coffee,  liquors  (unless  indicated  by 
the  doctor). 

300 


APPENDIX  B 

The  following  is  an  ample  daily  intake  for  an 
average  adult,  in  good  health,  which  has  been 
arranged  by  my  friend  Dr.  William  H.  Porter.  It 
will  be  observed  that  many  foods  in  general  use, 
are  not  mentioned,  and  other  common  foods 
though  not  absolutely  interdicted,  are,  nevertheless, 
either  advised  against  or  are  advised  to  be  taken 
sparingly,  occasionally,  and  not  as  part  of  one's 
steady  diet.  For  those  suffering  real  ailments, 
such  as  diabetes,  liver  affections,  and  the  like, 
special  diets,  different  from  such  as  here  given, 
are  indicated. 

Eggs,  milk,  wheat,  bread  and  butter,  and  beefsteak,  should 
be  the  staples.  Beefsteak  is  mentioned  as  the  working  standard 
among  meats,  as  it  is  the  most  easily  digested  of  all.  But  we 
may  eat  instead,  lamb,  mutton,  and  occasionally  veal;  all 
kinds  of  fish,  including  oysters,  clams,  lobsters,  and  crabs; 
all  kinds  of  poultry  and  game.  The  meats  to  be  broiled, 
boiled,  or  baked;  the  fish  to  be  broiled  or  baked;  the  oysters 
and  clams  raw  or  stewed;  the  lobsters  plain  boiled.  A  little 
crisp  bacon  from  time  to  time;  also  ham  and  corned  beef, 
better  without  cabbage.  Eggs  boiled,  poached,  or  scrambled. 
Milk,  plain,  preferably  warmed,  with  a  little  limewater  (one 
tablespoonful)  added.  Wheat  bread  is  taken  above  as  the 
standard  because  it  is  the  most  easily  and  perfectly  digested. 
It  should  be  at  least  twenty-four  hours  old  and  preferably 
toasted.  Rye,  graham,  zweiback,  or  the  various  health-food 
breads  may  at  times  be  substituted.  Weak  coffee,  or  tea, 
without  milk  or  sugar,  or  with  a  dash  of  milk,  may  be  taken 
sparingly,  two  or  three  cups  the  day;   either  beverage,  taken 

301 


WHY  DEE  SO  YOUNG? 

clear,  aids  digestion,  but  with  milk  and  sugar  often  disturbs 
digestion. 

We  may  enlarge  the  above  diet  by  adding  string  beans, 
green  peas,  lima  beans,  spinach,  lettuce,  asparagus,  and  cauli- 
flower, vegetables  the  least  likely  to  excite  intestinal  fermen- 
tation. They  should  be  well  cooked,  only  one  of  them  at  a 
meal;  and  when  taken  with  the  meal  there  should  be  a  reduc- 
tion in  the  above  quantities  of  meat  or  milk.  We  may  also 
add  boiled  rice  and  macaroni,  and  occasionally  boiled  beets, 
carrots,  turnips,  and  squash.  Small  quantities  of  cereals  may 
be  taken  as  part  of  breakfast;  but  cereals  as  the  exclusive 
breakfast  food  are  far  from  being  sufficient  or  sustaining. 

The  following  foodstuffs  should  be  taken  sparingly,  many 
of  them  not  at  all.  All  fruits,  either  cooked  or  raw,  nuts,  sweets, 
and  pastries  of  all  kinds,  potatoes,  onions,  tomatoes,  parsnips, 
celery,  radishes,  cabbage,  eggplant,  oysterplant,  pork,  except 
as  ham  or  bacon,  rich  gravies,  and  most  soups.  Soups  tend  to 
destroy  the  keen  appetite  which  makes  possible  the  eating  of 
plain  and  substantial  food;  also  they  stimulate  a  strong  desire 
for  highly  seasoned  food;  also  the  mixed-cream  and  rich-stock 
soups  tend  to  excite  undue  and  putrefactive  fermentation 
(auto-intoxication  in  the  intestines).  Rich  gravies  disturb 
digestion. 

Potatoes,  so  universally  used,  have  these  objectionable  fea- 
tures; they  have  a  high  starch  and  a  low  proteid  percentage; 
they  are  often  eaten  fried;  the  starch  which  they  contain  is 
rapidly  digested  and  assimilated.  The  yield  of  this  product 
is  only  animal  heat;  not  animal  blood  and  muscle.  Such 
material  cannot  take  the  place  of  the  proteid  constituents 
of  food,  which  are  so  necessary  to  the  maintenance  of  perfect 
health.  The  same  reasoning  holds  true  of  most  of  the  above- 
mentioned  articles  usually  employed  as  food.  Fruits  are 
usually  picked  before  they  are  fully  ripe;  or  they  are  in  a  state 
of  partial  putrefaction,  and  they  are  often  covered  with  bac- 
terial life.  Having  reached  the  alimentary  canal  in  one  or 
more  of  these  states,  they  excite  undue  and  putrefactive  fer- 
mentation and  thus  prevent  the  right  digestion  and  assimila- 
tion of  the  proteid  animal  elements  of  the  food — beef,  eggs, 
and  the  like.  By  following  the  above  advice  a  sufficiently 
varied  diet  can  be  secured  and  a  high  grade  of  nutrition  can 
be  maintained. 

302 


INDEX 


A 


Abbey's  "  Sir  Galahad,"  89. 

Abbott,  Rev.  Dr.  Lyman,  293. 

Abdominal  distress,  149. 

Abscess:  in  ear,  69;  in  brain,  69, 
180;  in  teeth,  73;  mastoid,  97, 
103;   pulmonary,  269. 

Acidity,  221. 

Acidosis,  98. 

Adanson,  French  naturalist,  285. 

Adenoids,  11,  46,  56,  72,  74-78,  80, 
81,  98,  263. 

Air,  fresh,  37,  38,  39,  40,  134. 

Albinos,  4. 

Alcohol:  use  of,  93,  94,  134,  209, 
210,  212,  213,  218,  222,  235,  236, 
242,  257;  and  venereal  diseases, 
95;  and  pneumonia,  108;  inter- 
feres with  digestion,  147;  and 
efficiency,  188-191;  benefits  of, 
191-193. 

Alcoholic:  taint,  5,  6;  neuritis, 
171,  172. 

Alcoholism,  93,  150,  151,  168,  169, 
170,  171,  172,  236,  267,  270. 

American  Society  for  the  Control 
of  Cancer,  204. 

Anaemia  (blood  poverty),  11,  55, 
58,  91,  149,  207,  235,  237. 

"Anaemic  murmur,"  235. 

Anaesthesia,  208. 

Aneurism,  236. 

Angina,  266. 

Anthrophobics,  165. 

Antitoxins,  56,  67. 


Anti-venines,  66. 

Aortic  valve,  149. 

Aphasia,  243. 

Apoplexy,  187,  201,  240,  244,  270- 
272. 

Appendicitis,  in  unborn,  56. 

Appendix,  the,  56,  57,  181. 

Arcus  senilis,  260. 

Arsenic:  poisoning,  72;  of  the  Ty- 
rol, 93;  Fowler's  solution  of,  169. 

Arteries:  hardening  of,  146,  147, 
149,  217,  229,  235,  236,  238,  241- 
245,  267;  plugging  up  of,  182, 
270,  271. 

Arterio-sclerosis,  242-245,  269, 
270. 

Asthma,  91,  105,  262-267. 

Astigmatism,  70. 

Athlete's  heart,  149-151. 

Athletic  training,  150,  151. 

Atmosphere,  polluted,  99,  105. 

Aural  diseases,  68-70. 

Auto-intoxication,  148,  149,  180, 
234. 

AutotOxemia  (self -poisoning),  73, 
148,  149. 

B 

Babies:  average  of  deaths,  19; 
sickly,  21,  22;  weaning,  24,  25, 
297-300;   bottle-fed,  26-29. 

Bach,  Sebastian,  6. 

Bach,  Weit,  6. 

Bacillus,  tubercle,  transmission  of, 
8,  10. 

Baobab  tree,  285. 


303 


WHY  DIE  SO  YOUNG? 


Bathing,  118-120. 

Baths:  shower,  48;  cold,  45,  101; 
warm,  10,  275. 

Batophobia,  165. 

Beauty  doctors,  120. 

Bedrooms,  ventilation  of,  39. 

Beecher,  Henry  Ward,  151. 

Beefsteak,  301. 

Beer:  little  nutritive  value,  23; 
fat,  218. 

Being  Done  Good,  233. 

Betel-nut  chewing,  cancer  from, 
207. 

Billroth,  290. 

Binet,  Doctor,  82,  83. 

Birthmarks,  120,  121. 

Blackwell,  Dr.  Elizabeth,  17. 

Blaikie,  How  to  Get  Strong  and  How 
to  Stay  So,  126. 

Blood:  good,  6,  7;  disease,  7,  8; 
circulation,  44,  45;  acidity  of, 
98;  stagnation,  119;  pressure, 
146-148,  187,  236,  238,  243;  let- 
ting, 148,  238;  supply,  278. 

Blood  vessels,  rupture,  270. 

Body,  keep  warm,  135. 

Bones,  broken,  46. 

Bottle-fed  babies,  26,  27,  28,  29. 

Brain,  the,  83,  270,  277,  278. 

Bread:  hot,  267;  wheat,  301. 

Breast:  milk,  24;  soreness  of,  205. 

Breath,  shortness  of,  91,  150,  187, 
237,  262,  267. 

Bright's  disease,  149,  210,  211,  217 
227,  228,  236. 

Brillat-Savarin,  The  Physiology  of 
Taste,  224;  quotations  from, 
225,  226,  227;   aged  aunt,  295. 

Brockton,  an  aristocracy  at,  18,  19, 
20,  21. 

Bronchitis,  68,  73,  74,  76,  80,  105, 
106,  262,  267,  268. 

Buccal  cavity,  germs  in,  100. 

Buffon  and  human  maturity,  283, 
284. 


Bull,  Dr.  William  T.,  56,  57. 
Bunions,  123. 
Bunyan,  John,  60. 
Butter,  fattening,  145. 


Cabot,  Dr.  Richard  M.,  190. 

Caesar,  Julius,  292. 

Caffein,  effect  of,  on  blood  pres- 
sure, 147. 

Cakes,  55. 

Calabar  bean,  93. 

Calcium  hypochlorite,  41,  42. 

Calf  lymph,  government-tested, 
177. 

Calluses,  124. 

Calories,  42,  43 

Campbell,  Dr.  Harry,  55. 

Camp  infections,  preventive  meas- 
ures against,  173,  174. 

Camp,  Walter,  system  of  exercise, 
245-249. 

Cancer,  7,  120,  121,  174,  199,  200, 
202-209,  236. 

Candy,  develops  energy,  55. 

Carbohydrates,  43. 

Cardiac  asthma,  262. 

Cartilages,  ossified,  232. 

Cataract,  260-262. 

Catarrh,  68-70,  73,  74,  77,  91,  98, 
99,  102,  172,  173,  221,  222. 

Cavities,  tooth,  72,  180,  231. 

Cell  evolution,  the  theory  of,  286, 
287. 

Cells,  the  body,  286-288. 

Cereals,  302. 

Chamberlain,  Joseph,  290. 

Cheyne,  quoted,  245. 

Cheyne-Stokes,  respiration,  228. 

Childhood,  development,  31-36; 
infections,  52,  53. 

Children's  Bureau  of  the  Depart- 
ment of  Labor,  reports,  18,  19, 
20. 


304 


INDEX 


D 


Child's  development,  the,  31-36. 

Chill,  the,  101,  107. 

Chittenden,  Professor,  211,  £13.  Darwin,  2,  12. 

Chlorosis  (green  sickness),  235.  Darwinian  law,  15. 

Cholera,  Asiatic,  42,  67,  173,  174;  Deafness:     cause,    78,    172;     the 

hog,  250.  tragedy  of,  255-258. 

Chorea  (St.  Vitus's  dance),  78,  79,  Death  rate,  the,  200,  249-252. 


Deaths:  from  tuberculosis,  60; 
from  preventable  diseases,  142, 
143;  from  smallpox,  179;  from 
cancer,  203,  204,  209. 

Deformities,  61,  62. 

Delano,  F.  A.,  247. 


161,  182. 
Cigarettes,  injurious,  91,  92. 
Circulation  of  blood,  44,  45. 
Cloak  rooms,  48. 
Cocaine,  262. 

Cocoa,  for  nursing  mothers,  23. 
Coffee,  use  of,  93,   153-155,  222,    Dental  floss,  72. 

235,  236,  301,  302.  Dentifrices,  72,  108. 

Cold:  in  the  head,  73,  74, 102,  105;    Diabetes,  72,  168,  182,  222,  228- 

common,  97-102;  neglected,  97;        231,  236,  242,  261,  269. 

causes  of,  98,  99;  catching,  100,    Diastolic  pressure,  146. 

101;    prevention   of,    100,    101,    Dickens,  Charles,  198. 

102;  "chronic,"  172.  Dietary:    for  one  day,  213,  214, 

Cold-water  baths,  45,  101.  245;  for  gout,  215,  216;  for  the 

Complexion  improver,  a,  127,  128.        obese,  218,  219;  for  building  up 


Connor,  Professor,  164. 

Constipation,  265. 

Consumption,  8,  9,  109-118,  182, 
186,  267. 

Conway,  Rev.  Dr.  Moncure,  293. 

Cooking,  good,  222. 

Cooks,  poor,  251. 

Consumptive  patient,  the,  115- 
117;  his  doctor,  117,  118. 

Corn-meal  gruel,  for  nursing  moth- 
ers, 24. 

Corns,  123,  124. 

Coryza,  68,  77,  91,  102. 

Cotton-mill  industry,  200. 

Cousins,  marriage  of,  4. 

Cowpox,  66. 

Cows,  feeding,  25. 

Cromwell,  294. 

Crosby.  Secretary,  248. 

Cup,  common,  source  of  infection, 
101,  104. 

Curran,  Dr.  John  F.,  186. 

Curriculum,  school,  54. 


the  system,  220;  for  diabetics; 
231;  for  asthmatics,  266,  267; 
for  elderly  people,  289;  for  the 
child  from  time  of  weaning  to  its 
fifteenth  month,  297,  298;  from 
eighteenth  to  twenty-fourth 
month,  298,  299;  during  the 
second  year,  299,  300;  daily,  for 
average  adult,  301,  302. 

Diet,  for  nursing  mother,  23,  24; 
daily,  301,  302. 

Digestion,  poor,  99,  302. 

Digestive  juices,  71. 

Digestive:  organs,  59;  juices,  71; 
disorders,  234. 

Diphtheria,  52,  56,  60,  65,  67,  68, 
71,  73,  77,  168,  181,  227,  236. 

Disease  prevention,  195,  197. 

Diseases,  germ-induced,  22;  sex- 
ual, 95,  96;   degenerative,  200. 

Disinfecting  solutions,  108. 

"  Divine  healers,"  250. 

Dizziness  (Syncope),  244. 


305 


WHY  DIE  SO  YOUNG? 

Dragon  tree,  285.  p 

Draughts,  38,  40,  101. 

Drill,  military,  132,  133.  Factory  workers,  female,  200. 

Drinker,  the  moderate,  209,  210.  Fatigue:   and  efficiency,  108,  188; 

Drugs,  use  of,  147,  151-153,  161,  dyspepsia,  158-160. 

238,  239,  275.  Fats,  43. 

Drummond,  Henry,   The  Greatest  Fattening  foods,  145,  146. 

Thing  in  the  World,  166.  Fear,  164,  165. 

Dunn,  J.  B.,  223.  Feeble-minded,  81,  82,  83. 

Dust,  germ-laden,  98;    city,  263,  Feeding,  bottle,  26-29. 

266.  Feet:     wet,    98,    105,    107,    290; 

Dysentery,  42,  269.  swelling  of,  237. 

Dyspepsia,   55,   56,   71,    158-160,  Fetra,  Dr.  L.  L.  La,  47. 

220,  221.  Fever:  Scarlet,  52,  59,  65,  67,  68, 
v  71,  73,  77,  106,  168,  227,  236; 
typhoid,  56,   60,   67,   105,   145, 
Earache,  76.  150,  168, 170,  173-176,  229;  yel- 
Ear,   middle:    running,   58,    181;  low,   67;     "lung,"    108;    after- 
inflammation  of,  68,  69,  70,  172;  noon,  112;  rheumatic,  232. 

257;  catarrhal,  231.  Filipinos,  vaccinated,  179. 

Ears,   ringing   in,   172,   244,   255,  Filters,  water,  41,  42. 

257.  Fingers,  dirty,  101,  174. 

Eczema,  149,  265.  Finley,  Dr.  John,  128. 

Eliot,  Doctor,  195.  Fisher,  Prof.  Irving,  190. 

Embolus,  271.  Fit,  epileptic,  162. 

Emerson,  quoted,  281.  Flatfoot,  244. 

Emotions,  the,  160,  163,  164.  Flexner,  Dr.  Simon,  53. 

Environment,  13,  14,  18,  158.  Food,  42,  43,  99,  145, 146, 149,  213, 

Epidemics,  41,  64,  100,  101,  102,  214,  218,  219,  220,  222,  231,  289, 

103,    104,   106,    175,    177,   194,  297-302. 

251.  Foods  for  the  nursery,  forbidden, 

Epilepsy,  265.  300. 

Epileptics,    marriage   of,    4;     off-  Fowler's  solution  of  arsenic,  169. 

spring,  12.  Franklin,  Benjamin,  190. 

Erysipelas,  168,  236.  Fried  food,  222. 

Eugenics,  science  of,  1,  2,  3,  4.  Fruits,  302. 

Examinations,  physical,  142,  143,  Function,  13. 

165,  184-187,  206,  219,  230,  233,  q 

236,  243,  247,  249. 

Exercise,  49,  50,  124-126,  131,  146,  Gall  stones,  181. 

245-249,  289,  290.  Galton,  Francis,  founder  science  of 

Extremities,  swelling  of,  187.  eugenics,  1,  3,  12,  295. 

Eye:  defects,  70, 71;  strain,  79, 81,  Gangrene,  244,  269. 

156,  257,  261,  263.  Garbage,  disposal  of,  37. 

Eyes,  inefficient,  259.  Gargle,  solution  for,  59,  108. 

306 


INDEX 


Gas:  oxygen  -  consuming,  105; 
stomach,  98,  234;  laughing,  208. 

Gastric:  juice,  221;  catarrh,  99, 
221,  222. 

Gastritis,  221,  222. 

Gentian  of  the  Alps,  93. 

Germs,  disease,  41,  57,  58,  69,  70, 
73,  78,  97,  104,  105,  106,  108, 
176,  180,  181,  198,  263. 

Gibbs,  Philip,  279. 

Gladstone,  290,  294. 

Glands,  enlarged,  11. 

Glasses,  fitting  of,  261,  262. 

Glaucoma,  261. 

Goiter,  180. 

Goldsmith,  Oliver,  126. 

Gout,  203,  211,  214-216,  222,  230, 
242,  265,  267,  270,  271. 

Gravies,  rich,  302. 

Green  sickness,  235. 

Grippe,  the,  52, 60, 68, 73, 102, 103, 
168,  257. 

Gums,  neglected,  58,  59,  71;  un- 
healthy, 180,  233. 

Gymnasium,  in  schools,  48. 

Gynephobics,  165. 


Hall,  Dr.  J.  Stanley,  49. 

Haller,  and  human  maturity,  283. 

Hapsburg,  family  characteristics, 

14. 
Hare-lip,  4. 
Hawthorn,  Julian,  Archibald  Mai' 

maison,  13. 
Hay-fever  asthma,  262,  263. 
Hazlitt,  127,  131. 
Headache  "  cures,"  153,  235. 
Health  Department,  194,  195. 
Hearing,  defective,  67,  68. 
Heartburn,  55,  91,  234. 
Heart:     undersized,    11;     disease, 

57,  97,  103,  174,  180,  181,  182, 

187,  201,  239,  240,  270;  palpita- 


tion, 149,150, 165, 187;  athlete's, 
149,  151;  muscles,  150;  beats, 
234;  functional  disturbances, 
234-236;   fatty,  271. 

Heating  method  for  schools,  48. 

Heels,  French,  123. 

Helmet  of  Minerva,  the,  162. 

Helmet,  woolen,  113. 

Hemorrhage,  244. 

Heredity,  1,  2,  3,  6,  12,  13, 14,  18, 
158,  204,  229. 

Hernia,  186,  187. 

Hip  disease,  62. 

Hives,  149,  265. 

Hobbies  for  the  old,  290. 

Holmes,  Oliver  Wendell,  163. 

Hoof-and-mouth  disease,  250. 

House  of  Seven  Gables,  The,  13. 

Houses,  ventilated,  99;  super- 
heated, 99,  105. 

Human  being,  perfect,  183. 

Human  maturity,  the,  282,  283, 
288. 

Hunchback,  62. 

Huntington,  Rev.  Dr.  W.  R.,  293. 

Hutchinson,  Dr.  Woods,  179. 

Huxley,  quoted,  135,  136. 

Hydrophobia,  66. 

Hygiene, departments  of  school, 54. 

Hygienic  life,  the,  134-135. 

Hypertension  sufferers,  147,  148. 

Hypochlorite  of  lime,  41,  42. 

Hysteria,  160-163;  cause,  161;  imi- 
tation, 161;  symptoms,  161, 162; 
treatment,  162,  163. 


Idiots,  81,  82,  83. 

Illumination,  improper,  259,  260. 

Imbeciles,  marriage  of,  4;  off- 
spring, 12;  grade,  81,  82. 

Imitation,  13,  14,  161. 

Immunity  against  infectious  dis- 
eases, 65-67. 


307 


WHY  DIE  SO  YOUNG? 


Immunizing  agents,  67. 
Index  card,  53. 
Indian  hemp,  93. 
Indigestible  food,  99. 
Indigestion,  55.  71,  80,  91,  99,  149, 

210,  267. 
Industrial  surgeon,  the,  184-187. 
Inebriates,  offspring  of,  5,  6. 
Infantile  paralysis,  52,  56,  62-65;    Edieyr^oval  of  or 

cause   of,    63;     symptoms,    64;    Ki  lin     Rudyard>  163 

treatment,   64,   65;    preventive 

measures,  65. 
Infants:    degenerately    born,    12; 

sickly.  15,  16,  21,  22;  artificially    Kumiss*24 

fed,    21,    22,    26-29;    benefited 

by    sea   air,    22,    23;    weaning, 

24,  25,  297-300;   development, 

31-36. 
Infection:  centers,   180- 

183;  "mixed,"  181. 
Infections,   childhood,   prevention 

and  treatment,  198. 
Influenza,     102-106;      symptoms, 

102,  103;   contagious,  104;    im-    Laryngitis,  80 

munity  to,  104;  control  of,  104,    Lateral  curvature,  61,  62 


Kankri  cancer,  207. 

Keel  breast,  77. 

Kidney  disease,  97,  103,  180,  181, 
201,  265,  267-270. 

Kidney  excretions,  230;  examina- 
tion of,  244. 


Kissing,      germs      transmitted 

through,  101,  104. 
Koch,  195. 


Kyphosis,  62. 


Land  settlements  for  soldiers  and 

sailors,  136. 
Lane,  Franklin  K.,  136,  248. 
Langtry,  Lily,  127. 


105. 
Infusoria,  one-celled,  284,  285. 
Ink  drinking,  155. 
Inoculation,  typhoid,  175. 
Insomnia,  114,  148,  273,  274,  275. 
Insurance,  life,  142. 


Lead:  poisoning,  72,  242,  271 ;  and 

neuritis,  169. 
Le  Bon's,  The  Crowd,  A  Study  of 

the  Popular  Mind,  75. 
Lecky,  Map  of  Life,  139. 
Legs,  swelling  of,  237. 


Intestines,   paralysis  of  muscular    Life  expectancy  after  forty,  197- 

movements,  164.  202. 

Irritation,  factor  of  chronic,  213,    Lightning,  commercial,  259. 
214.  Lincoln,  292,  294. 

Lip  cancer,  206. 
J  Lisp,  4. 

Liver:    torpid,   149;    reduced  by 

surgery,  277;  hobnail,  288. 
Living,  fast,  240. 
Lockers,  individual,  48. 
Lordosis,  62. 
Lumbago,  149. 
Lung  fever,  108. 
Lungs,  reduced  by  surgery,  277. 
308 


Jacobi,  Dr.  Abraham,  44. 
James,  Henry,  166. 
James,  Prof.  William,  166. 
Jenner,  Doctor,  66,  178. 
Johnson,  Samuel,  126. 
Joint  affections,  265. 
Joints,  deformed,  232,  233. 


INDEX 

j£  of.  25,  26;  cooling,  25,  26;  keep- 
ing, 26;  substitute  for  mother's 

McAdoo,  Secretary,  247.  milk,  27,  28;  hot,  114,  148. 

Macy,  Dr.  Mary  Sutton,  166,  167.  Moles,  120,  121. 

Malaria,  105,  145,  150,  168,  170,  Morality,  84-86. 

173,  176,  177,  230.  Morons,  81,  82. 

Malnutrition,  53,  54,  55.  Mosquito,  Anopheles,  176,  177. 

Malt  extracts,  increase  milk  flow.  Mother:    medical  care,  20;    con- 

24.  sumptive,  21,  26;    nursing,  23, 

Marriage:  of  blood  relations,  4-6;  24. 

of  the   tuberculous,   8,   9;    age  Mother's  milk,  substitute  for,  21, 

suitable  for,  138-141.  26,  27,  28,  29. 

Mastoid  process,  69.  "  Motor  ear,"  the,  257. 

Maturity,  periods  of,  282,  283,  288.  Mouth-breathing,  11,  72,  76. 

Measles,  52,  60,  65,  68,  71,  73,  77,  Mouth,  cleansing,  71,  72,  100,  108. 

103,  105,  106,  168,  227,  236.  Mumps,  52,  68,  73. 

Meat,  overeating,  211.  Muscle:  culture,  48,  49,  50;  waste, 

Meats,  301.  126. 

Meats,  and  blood  pressure,  146.  Muscular  system,  48,  49,  50,  124, 

Medical:    school   inspections,   52.  131. 

53,  54;  examinations,  165,  184-  Music,  290,  291. 

187,  219,  230,  233,  236,  243,  247;  Mutes,  deaf,  4. 

trust,  250.  Myopia  (nearsightedness),  70. 
Medicine,  preventive,  194,  195. 

Medicines,  proprietary,  115,  169,  jj 

250. 

Membrane,    mucous,    11,   97,   98,  Nasal  discharges,  73,  76,  172. 

100,  172,  262.  Nascher,  Dr.  J.  L.,  theory  of  old 

Memory,  loss  of,  243,  244,  270.  age,  286,  287. 

Mendelian  theory,  4,  12.  Nature  of  Man,  The,  284. 

Meningitis,  67,  70,  103,  257,  269.  Negroes:   tuberculosis  in,  60;   im- 

Mental  defects,  81-84.  mune  against  yellow  fever,  67. 

Mental  illness,  191.  Nephritis,  acute,  227,  228. 

Mercury  may  cause  neuritis,  169.  Nerve  tests,  155,  156. 

Mercurial  poisoning,  72.  Nervous  system,  5,  102,  131,  132, 

Metabolism,  102, 126,214,216,217.  156-159,  230,  262,  265,  291. 

Metallic  poisoning,  72,  168,  169.  Neuralgia,    149,    235,    265,    266; 

Metchnikoff,  and  human  life  span,  "  cures,"  235. 

284,  285,  286.  Neurasthenia,  98,   149,   155,   156, 

Militia,  the,  132-134.  157,  158,  159,  164,  265. 

Milk,  cow's:    for  infants,  21,  24;  Neuritis,    168-172;     causes,    168, 

germs  in,  22,  25,  28;  for  nursing  169,   170,   180;    a  case  history, 

mothers,    24;     fermented,    24;  170,  171,  172. 

graded,    24;     pasteurized,    25;  Newton,  Dr.  Richard  Cole,  128. 

loose,  25;    safeguarding  purity  Newton,  Secretary,  248. 

21  309 


WHY  DIE  SO  YOUNG? 


Nicotine:  poisoning,  91;  effect  on    Physical  resources,  278,  279,  280. 


blood  pressure,  91,  147. 
Nightmare,  80. 
Night  sweats,  112. 
"  Nocturnal  asthma,"  265. 
Nose  excretions,  46. 
Noses,  inflamed,  68. 
Nostrums,  169. 
Nurseries,  ill- ventilated,  74. 
Nursing  mother,  diet  for,  23,  24. 
Nutritional  disorders,  54-56. 


0 


Physical  training,  49,  131,  132. 
Plague,  the,  173. 
Plasmodium  malaria,  176. 
Playgrounds,  48,  50. 
Pleurisy,  182,  235,  269. 
Pneumonia,  60,  68,  73,  74,  97, 106- 

109;    145,   174,   181,  201.  257. 

268,  269. 
Poisons,  metallic,  72,  168,  169. 
Polypi,  78,  263. 
Porter,  Dr.  William  H.,  Food  as  an 

Aid  to  Long  Life,  192;  daily  food 


intake  arranged  by,  301,  302. 

Obese,  dietary  for  the,  218,  219.  Post,  Louis  E.,  248. 

Obesity,     216-219;      "diabetoge-  Post-mortem    examinations,    278, 

nous,"  229.  284. 

Oil,    petroleum,    for    mosquitoes,  Potatoes,  302. 

176.  Pott's  disease,  17,  62. 

Old  age,  what  is,  283-286.  Prayer,  291-295. 

Operations:    for  adenoids,  78;    for  Prayer,  Nature  of,  293. 

enlarged  tonsils,  78;   for  cancer,  Precancerous  stage,  the,  205,  206, 


208,209;  for  cataract,  262;  sur- 
gical, 277,  278. 

Ovarian  affections,  265. 

Overeating,  99,  146,  147,  210-213, 
216,  242,  265,  270. 

Overweights,  216,  217. 

Oxygen,  life-maintaining  gas,  11, 
38,  39,  45. 

P 

Pace  that  kills,  the,  239,  240. 
Pancreas,  the,  229,  277. 
Pantaphobia,  165. 
Paralysis,  244,  271. 
Paratriptics,  93,  94. 
Pasteurizer,  Straus,  25  n. 
Pasteur  treatment,  66,  195,  198. 
Patent  medicines,  115,  169,  250. 
Pathophobia,  165. 
Peritonitis,  269. 
Peruvian  cinchona,  93. 
Phobias,  164,  165. 
Phosphorus  poisoning,  72. 


208. 
Predisposition,  106,  107,  108,  110. 
Profiteers,  250. 

Prolongation  of  Life,  The,  284. 
Protein,  43. 

Psychasthenia,  155,  158. 
Public  health,  the,  193-195. 
Pulse,  234. 

Puncture,  lumbar,  56. 
Pyorrhoea  alveolaris,  72. 


Quinsy,  77. 


R 


Radiography,  259. 
Radium  burns,  cancer  from,  206. 
Rankin,  Dr.  Guernsey,  156. 
Reducing,  219. 

Refraction,  errors  of,  70,  156,  257. 
Renal  asthma,  262. 
Rest,  sufficiency  of,  135;   how  to, 
165-168. 
310 


INDEX 


Retinal  sclerosis,  243. 

Retinitis,  260,  261. 

Rheumatic  heart  disease,  57. 

Rheumatism,  57,  58,  59,  60,  78,  97, 
149, 150,  170, 180, 181, 182,  231- 
233,  236,  242,  267,  270. 

Rheumatieus,  streptococcus,  germ, 
57,  58. 

Rhinitis,  hypertrophic,  263. 

Rickets,  72,  261. 

Riggs's  disease,  72,  73. 

Rontgen  rays,  164. 

Roosevelt,  Colonel,  180. 

Root,  Elihu,  193. 

Rosenau,  Professor,  195. 

Rubbing,  45. 

Rugs,  preferable  to  carpets,  37. 

Rupture,  186. 


Saccharin,  231. 

Safety,  factors  of,  276-282. 

Salisbury,  the  Archbishop  of,  290, 
293. 

Saliva,  /l,  91. 

Sanitary  conscience,  195,  196. 

Sanitation,  home,  37. 

Scarlet  fever,  52,  59,  65,  67,  68,  71, 
73,  77,  106,  168,  227,  236. 

School  child,  the,  46,  47;  sense 
training  for,  50,  51,  52. 

School,  the,  47-49;  medical  inspec- 
tions in,  52-54;  hot  lunches  in, 
55,  56. 

Sclerosis,  retinal,  243. 

Scoliosis,  61,  62. 

Scrofulous  children,  10,  11. 

Sedentary  occupations,  126. 

Sense  training,  50,  51,  52. 

Septum,  deflected,  98,  263. 

Serum,  anti-meningitis,  56. 

Sexual  intercourse,  95,  96;  dis- 
eases, 95,  96. 

Shoe  faults,  122,  123,  124. 

Siesta,  afternoon,  146. 


"  Sir  Galahad,"  by  Abbey,  89. 
Skin:  stimulating,  45;  and  bodily 

waste,   101;    bathing  the,   118; 

an   organ   of   respiration,    119; 

cancer,  120,  121. 
Sleep,  127,  134, 146,  160,  167,  272- 

276. 
Sleeping  bags,  114. 
Sleeping  garments,  46. 
Sleeping  room,  ventilation  of,  40. 
Smallpox,  56,  66,   103,  168,   173, 

175,  177-179. 
Smiling  Joe,  17. 
Smokers,  moderate,  289. 
Snuffles,  73,  74. 
Sobriety  makes  for  long  life,  134, 

135. 
Soul,  the,  287. 
"Soul's     Awakening,    The,"     by 

Zant,  87,  88,  89. 
Soups,  302. 

Southworth,  Dr.  Thomas,  28. 
Sphygmomanometer,  the,  146, 147, 

236,  238. 
Spinal  curvature,  61,  62,  123. 
Spinal  douches,  157. 
Spittoon,  113. 
Sputum,  blood  in,  111,  112. 
Squint  (strabismus),  4,  70,  71. 
Stammer,  4. 
Sterilized  water,  41,  42. 
Stevenson,   Robert   Louis,  "  Pity 

Sick  Children,"  57. 
Stillborn,  12. 
Stimulants,  153,  154,  155. 
Stomach:  disorders,  205,  220,  221; 

gnawing  in,  221;  tube,  221;  gas, 

234;  overloading,  265,  267. 
Stoves,  in  bedrooms,  39;  in  living 

rooms,  99. 
Strabismus  (squint),  70,  71. 
Streptococcus  rheumatieus,  231. 
Strychnine,  93. 
St.  Vitus's  dance,  49,  78,  79,  161, 

182,  236. 


311 


WHY  DIE  SO  YOUNG? 


Sugar,  excess  of,  55,  228,  229;  fat- 
tening, 145;  sickness,  229. 
Suggestion,  force  of,  161. 
Sunshine,  best  disinfectant,  37. 
"  Sure  Cures,"  232,  233,  250. 


Tonsils,  enlarged,  11,  46,  56,  57, 
58,  72,  77,  78,  81,  98,  263;  in- 
fected, 181,  182,  231. 

Tooth  cavities,  72,  180,  231. 

Toothpicks,  wooden,  72. 


Surgical  operations,  78,  208,  209,    Towel,  roller,  source  of  infection. 


260,  277,  278. 
Sweats,  night,  112. 
Sweet,  Edwin  F.,  248. 
Sweetbreads,  229. 
Swimming  tanks,  48. 
Syphilis,  168,  230,  270,  271. 
Systolic  pressure,  146. 


Tannin,  155. 

Tantrums,  80,  81. 

Tea,  use  of,  23,  93,  153-155,  222, 
235,  236,  301,  302. 

Teeth:  decaying,  4;  bad,  53,  55, 
58, 59, 81, 100, 180, 181;  hygiene 
of,  71-73;  cavities  in,  72,  180, 
231;  gritting  of,  76;  X-raying, 
180;  diseased,  181;  ulcerated, 
233. 


101,  104. 
Trait,  recessive,  4. 
Trephining,  272. 
Tuberculosis,    7-11,    60,    61,   97, 

103,    109-115,    168,    173,    181, 

182,  186,  187,  229,  236,  257. 
Tumors,  205,  206,  264. 
Tuke,  Dr.  Hack,  The  Influences  of 

the  Mind  on  the  Body,  164. 
Twain,  Mark,  101,  126. 
Typhoid  carriers,  174,  175. 
Typhoid  fever,  56,  60,  67,  105, 145, 

150,  168,  170,  173-176,  229. 
Typhus,  168,  173. 

U 

Udders,  cleaning,  26. 
Ulcer,  teeth,  73;  stomach,  180;  leg, 
187;  varicose,  187. 


Temperature,  indoor,  40;    school-    Underclothing,  wool,  134. 


room,  48. 
Tenements,  ill-ventilated,  108. 
Terminal  affections,  108,  269,  270. 
Tetanus  (lockjaw),  67. 
Thein,  effect  on  blood  pressure,  147. 
Three  Fates,  The,  13. 
Throat:  excretions,  46;  cancer,  206. 
Throats,  inflamed,  68,  172. 
Thrombus,  182,  271. 
Tilson,  Hon.  John  Q.,  249. 
Tobacco,  use  of,  90,  91,  92,  93, 134, 

222,  235,  236,  242,  257;    effect 

on  blood  pressure,  147. 
Toenails,  ingrowing,  124. 
Toes,  hammer,  124. 
Tongue,  cancer  of,  206. 
"  Tonics,"  157,  169,  170. 
Tonsillitis,  77. 


Undergarments,  59. 
Underweights,  219,  220. 
Uremia,  228. 

Uric  acid  in  the  circulation,  214. 
Uterine  affections,  265. 


Vaccination,  56,  66, 175, 177-179. 

Vaccine,  66,  178. 

Valvular  disease  of  the  heart,  149, 

232,  234,  236-239. 
Varicose  ulcer,  187. 
Vegetable,  302. 
Venereal  diseases,  95,  96,  191. 
Ventilation,  home,  37,  38,  80,  99, 

105;  schoolroom,  48. 
Vertebrae,  disease  of,  61. 
512 


INDEX 


Visual  defects,  189,  258-260. 
Vitamines,  43. 
Voltaire,  291. 

W 

Walking,  126-131. 

Warmth,  for  the  aged,  290. 

Warts,  120,  121. 

Washington,  292,  294. 

Water,  drinking,  36,  37.  40,  41,  42 

128,  134,  157,  245. 
Wax  in  ear,  68. 

Weaning  infants,  24,  25,  297-300. 
Weight,  reducing,  144, 145;  taking 

on  of,  145,  146. 
Weir-Mitchell  cure,  the,  157.        , 
Whitman,  Walt,  295. 
Whooping  cough,  52,  56,  65,  68, 

105,  111. 
Wiley,  Dr.  Harvey  W.,  190. 


Will,  the  human,  13,  96,  158,  160. 

249. 
Wilson,  294. 
Window  board,  39,  40. 
Winds,  sea,  germ-free,  22. 


X-ray  examinations,  73,  112,  18G\ 
208. 


Yellow  fever,  67. 

Young,  Arthur,  quoted,  137. 


Zant's,  "  The  Soul's  Awakening," 

87,  88. 
Zinc  may  cause  neuritis,  169. 


THE    END 


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